• Exclusive Screening of a Critically Acclaimed Short Film About Disability
• Opportunity to engage in a discussion with the award-winning Film Producer
• Holiday Networking
• Discussion: Home Sharing and Disability Care

Location: Zoom Session

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Name *

Connection to Home Sharing

• Individual
• Family
• Home Share Provider
• Home Share Coordinator
• Agency / Organization
• Other

If Other (Please Describe)

Agency / Organization Name

If representing an agency, please provide the name of your agency

Email *

Please Select the Session(s) You Plan to Attend: *

• Networking Session (Dec)

We encourage you to register for multiple sessions from our list of topics. There is no penalty if you are unable to attend all of them.

Do you require any accommodations to participate fully in this event? *

• Yes
• No

If yes, please specify what type of accommodation you require (e.g. close captioning, sign language interpretation, etc.)

Is there anything else we can do to make this event more accessible for you?

Additional Comments/Suggestions

Please use this field to suggest any specific topics or themes you would like to see in future Connect & Collaborate sessions

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