This online form is provided for you to register for a workshop of your interest. Upon completion of this form, fill in the security box and hit "submit" button. This will send your information. Once your information is sent to FMPTIC, a new web page will open, with a thank you message.

If this page does not open for you, your information was not successfully sent. If a page opens telling you that you have entered the wrong security code, hit your back button on your browser and re-enter the security code. Retry sending again, if this fails, please contact FMPTIC at 1-866-436-7842, ext. 107 to register.

Notice: If you have registered for one training/workshop already on this visit and wish to register for another, you will need to refresh this page. Make sure that when you refresh, you are given another security code from the previous registration. If you fill out the form again and the same security code is present as before, the registration will be denied authorization.

Date of Workshop:

Preferred Session: am pm
Select your preference if a morning or afternoon session is offered.

Location:

Name(s):

Agency/Organization:

Address (Work or Home):

City:

State: Zip:

Home Phone:

Work Phone:

Email Address:

Parents, Please Fill Out The Following:
Child's Name:

Birthdate:

Disability/Diagnosis:

If accommodations are needed please list details (i.e., interpreter, special diet).
Please specify below.

Family Matters will need at least 2 weeks prior to the date of the training
to process your accommodation requests.

Enter the security code in the box below and hit "SUBMIT".

Enter security code