Upon completing this Registration Form, please print it out and
mail your payment (If required, for the event)
The NEAT Center at Oak Hill
120 Holcomb Street
Hartford, CT 06112
When you submit the form on line (by pressing "Submit" below) we will confirm your registration when we receive your payment.
Please check one:
I am a:
Consumer with disability
Parent of individual with disability
Speech Language Pathologist
Type of Member
Individual Consumer Member
Provider Organization Member
Corporate Basic Member
I am not a member
Here is the event you are registering for:
Registration Procedure: Completed registration form and payment/information is requested two (2) weeks prior to the event. Paid Membership is required to receive the discounted rate.
Policies: NEAT reserves the right to substitute instructors, cancel, reschedule, and postpone events as necessary. Refunds are issued only for events cancelled by NEAT or if a written request is received five (5) business days prior to the event. Please send your cancellation request to firstname.lastname@example.org. I understand photographs/videos may be taken during events for potential use in the public media for marketing purposes. If I do not want my image to be made public, it is my responsibility to inform the NEAT staff.
I have read and understand NEAT's Policies.*