Request for a Presentation/Training/Event Participation

Request for a Presentation/Training/Event Participation

Thank you for your interest about the Family Infant-Toddler Services at the Kansas State School for the Blind. Please complete the form below, and a FIT team member will follow up with you about the details of your request.
Date of Request*

MonthDayYear
Name of Individual Making a Request (Contact Person)*

First NameLast Name
Role/Position
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Organization/School/Agency/Local Infant-Toddler Program*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County*
Person Completing This Form (if different from the individual making the request)

First NameLast Name
Email
example@example.com
Topics of Interest or Event Participation*

Overview of Family Infant-Toddler ServicesVision Screening for Infants and ToddlersUnderstanding the Impact of B/VI on Early DevelopmentEarly Intervention Strategies for Infants and Toddlers with B/VIIntroduction to Early Concepts of Orientation and MobilityCreating a Sensory-Rich Learning Environment at HomeParent-Child Interaction for Families with Children with B/VIUnderstanding Cerebral/Cortical Visual ImpairmentCreating a CVI-Friendly Environment at Home and Daily RoutinesExpanded Core Curriculum for Young ChildrenSupporting Development for Young Children with B/VIOther
Preferred Dates and Times (Please provide at least three options)*
Duration*

30 minutes1 hourOther
Estimated number of attendees*
Any accommodations or accessibility Needs*
Format*

VirtualIn-PersonOther
Location, if in-person

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Other information or Comments
We appreciate your interest in collaborating with FIT Services.

If you have any questions, please feel free to contact us at

Email: fit@kssdb.org

Telephone: (913) 645-5645
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