The College of Education

Assistive Technology Summer Institute
Registration Form

Please complete the following information

First name:       Last name:

Email address:

I would like to sign up for::

AT Summer Institute Council Bluffs - July 22-23
 At Summer Institute Iowa City - July 24-25

I will be taking the class for:

 Graduate Credit
 Undergraduate Credit
 A Certificate of Completion

Address
Street Address:
City
State:     Zip:  
Phone: (10-digit number required, include area code: No space or dashes)

Please type "icater08" in the verification box below.