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30th Anniversary Celebration
Home
About Us
EEDA Advisory Committee
Executive Staff
Services
Self Directed Services
Residential Services
Day Habilitation
Community Habilitation and ISS
Crisis
Overnight Respite
Adult Socialization
ADMISSIONS
Careers
WHAT'S NEW?
EEDA Archives
Donate
Advocacy
Contact Us
Employee Resources
Kinexion
30th Anniversary Celebration
Please register below by November 28, 2022 to attend EEDA's It's Complicated: Exploring Sexuality, Identity, and Relationship Issues for People with Intellectual Disabilities on December 03, 2022 at Hotel Indigo.
STOP!
Please do not register unless you are absolutely sure you are able to attend. In the event that you register and cannot attend, please call 631-369-7345 Ext. 117 or email info@eed-a.org in advance so we can offer your spot to someone on the waiting list.
I agree to confirm my registration prior to the event.
*
I Agree
*
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How many people will be attending?
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Name:
*
First
Last
Mailing Address:
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Line 1
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City
State
Zip Code
Country
Email Address:
*
Cell Phone:
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PLEASE LET US KNOW WHO YOU ARE
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Parent
Self Advocate
Professional
Family Member
Support Broker
Other
This program is funded through a Family Support Services grant from OPWDD.
If you are the parent or family member of an individual with intellectual disabilities or a professional using this information to assist those you support, please provide us with the:
Individual's Name:
*
First
Last
Individual's TABS ID#:
*
Is the Individual Enrolled in the MCBS Medicaid Waiver?
*
Yes
No
Does the Individual Have Medicaid?
*
Yes
No
Thank you for completing this form!
Please click the submit button below to complete your registration.
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