Registration Form Behavior, Social Skills and Autism Join us May 13, 2015 from 9:00 am– 3:00 pm for a FREE conference at the Days Inn and Suites Schoharie. Our presenter, James Ball Ed. D., BCBA-D, authored the book, Early Intervention and Autism: Real– Life Questions, Real– Life Answers. He is a nationally known speaker, who has toured with Dr. Temple Grandin. He will provide valuable expertise and practical advice on behavior, social Registration is due by Friday May 1, 2015 and is on a first come first served basis. Due to the expected interest in this FREE conference register early. Feel free to bring your own beverages and lunch is on your own. This form may be duplicated for additional attendees. One registrant per form, please. Please mail completed form to: Parent Technical Assistance Center c/o Southern Tier Independence Center 135 E. Frederick Street Binghamton, NY 13904 Phone: 607-724-2111 B e h a v i o r, Social Skills and Autism A FREE conference for parents and professionals Wednesday May 13, 2015 9:00am—3:00pm At the Days Inn and Suites First Name:____________________________ Last Name: ____________________________ Address: _______________________________ _________________________________________ skills and autism for early intervention to early elementary Email: _________________________________ aged children. Suggested au- Phone: _________________________________ dience would include parents individuals with autism. There will be a question answer session during the conference. Feel free to submit a question at the registration table. You can also register via the Web at : www.ptac-stic.com James Ball Ed. D., BCBA-D Sponsored By: Y and professionals working with Presented By: Parent: _____ Professional:____ Both:____ Our Keynote Speaker James Ball Ed. D., BCBA-D James Ball Ed. D., BCBA-D, is a Board Certified Behavior Analyst. He has been working in the field of autism for over 30 years. He provides behavioral, educational, residential and employment services to children and adults affected by autism. He is an Executive Chair, National Board of Directors, Autism Society. He is also an appointed community member to the Interagency Autism Collaborating Committee (IACC), a federal advisory committee established by the Combating Autism Act of 2006. James Ball Ed. D., BCBAD, also sits on the advisory board for the Autism Asperger’s Digest magazine and has been a featured author for the magazine for over 5 years. He has lectured nationally and internationally on various topics related to autism, such as early intervention, inclusion services, social skills training, and functional behavioral assessments. Behavior, Social Skills and Autism Registration/ Welcome 8:158:45 Key Note Address: Behavior , Social Skills and Autism 9:0010:15 Morning Break 10:1510:30 Behavior, Social Skills and Autism continued 10:30– 12:00 Lunch on your own 12:00– 1:00 Behavior, Social Skills and Autism question and answer session 1:003:00 The conference is being held at the Days Inn and Suites Schoharie 160 Holiday Way James Ball Ed. D., BCBA-D, book available for purchase at Amazon and Future Horizons Schoharie, NY 12157 Sponsored By: http://www.p12.nysed. gov/specialed/techassis t/ecdc/ Autism Society Of the Greater Capital Region 101 State St. Schenectady, NY 2305 Phone: 518-355-2191 Web: www.albanyautism.org
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