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Registration Form

Instructions

  • Complete the following information and click the SUBMIT button for online registration.
  • Submission of the online registration form sends an email request to The Boggs Center. Submission of the online form is not a confirmation of registration. When your form is received, Boggs Center staff will register you for the sessions requested, based on space availability.
  • A Confirmation Letter will be sent to you by mail when your registration is received. The letter will indicate the sessions for which you are registered, and if full, the sessions for which you are on the waiting list. If you do not receive a letter, please call The Boggs Center.
  • An Admission Pass will be sent to you by mail two weeks prior to each session. If you have registered for a session and cannot attend, please call The Boggs Center to cancel.
  • Please complete the “Accommodations needed” section for sign language interpreters, alternate
    formats, or other accommodations.
  • Any questions, please contact Debbie Mahovetz:
    Direct Line: 732-235-9543
    Main Line: 732-235-9300
    Email: deborah.mahovetz@rutgers.edu

Name and Contact Information All fields followed by an asterisk( * ) must be filled in.

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Registration Contact (if different from above)
DDLS Sessions
Please check the box(es) to indicate the session(s) you would like to attend:


Implementing Personalized Supports

Thursday, October 5, 2017
Interpreting and Responding to the Complex Needs of Persons with Dual Diagnosis



Promoting Health, Wellness, and Contentment in Older Adults with Developmental Disabilities
and their Aging Caregivers


For planning purposes, please let us know if you are a wheelchair user, or if you need Braille handouts, a Sign Language Interpreter, or other accommodations.

 

Continuing Education
The Boggs Center has applied for continuing education credit from the following organizations. If you are interested in receiving continuing education credit, please click on the checkbox below.


Please see the Continuing Education section for more information.

 
Additional Information
Please complete the following if you are not on our mailing list or wish to update your information:

 

What are your areas of interest? Check all that apply.



















 


Sends your application by email to The Boggs Center

Accessibility Statement
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