Futures Planning Workshop

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Please register below to attend EEDA's Futures Planning Workshop on December 5th, 2023 a 6:00 p.m. via Zoom.

A Zoom link will be sent out prior to the event.

* Indicates required field

Name *

First

Last

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Cell Phone: *

Please let us know who you are: *

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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​​Please register below to attend EEDA's Futures Planning Workshop on December 5th, 2023 a 6:00 p.m. via Zoom.

Please register below to attend EEDA's Futures Planning Workshop on December 5th, 2023 a 6:00 p.m. via Zoom.