Wednesday, August 10, 2005 at Northcentral Technical College (NTC) in Wausau
or Thursday, August 11, 2005 at Crowne Plaza in Madison, WI

CEU's (Continuing Education Units) Available!

Registration Fees:

Morning only: 8:30 a.m. to 1:00 p.m. - $40
Afternoon only: Noon to 3:30 p.m. - $40
Full Day: 8:30 a.m. to 3:30 p.m. - $65 Please check the box for the site you will be attending:

Wausau - August 10, 2005:	Madison - August 11, 2005:
Northcentral Technical College (NTC)	Crowne Plaza Madison
1000 West Campus Drive	4402 E. Washington Avenue
Wausau, WI 54401	Madison, WI 53704

Diet or Accommodation Requirements:

Please indicate diet or other accommodations you require (i.e. large print, interpreter, language translation, etc.). Requests must be made before the registration deadline of July 27, 2005. After the deadline, every effort but no guarantee will be made regarding your request:

NOTE: We ask that participants refrain from using any products with fragrance during the conference.

Diet:
Accommodation:

PRINT then MAIL or FAX this completed form with payment to:

RFW, Inc.
1302 Mendota Street, Suite 200,
Madison WI 53714-1024
or FAX to: 608-244-9097.

Questions? Contact: Tammy Liddicoat, ADA Wisconsin Partnership
608-334-8105 or email tliddicoat@charter.net

Financial support has been provided by Great Lakes ADA and Accessible IT Center through a grant from the National Institute on Disability Rehabilitation and Research, US Department of Education H133D010203.

REGISTRATION FORM

Registration Fees: