Registration Form: Statewide Sign Language Skill Development Workshop with Presenter Dr. Deb Cates
Registration Deadline: June 14, 2019
Workshop Location: Don Clifton Center (710 Hill Street; Lincoln, NE 68502)
Workshop Dates: July 18-19, 2019 (Participants are required to attend both days)
This workshop is free to participants employed in a Nebraska K-12 school district.  
Freelance interpreters not employed in a Nebraska K-12 school district may register by paying a registration fee of $50 and currently-enrolled students may register at a discounted rate of $25.
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Please select the Nebraska Regional Program with which you are affiliated *
First Name *
Last Name *
Preferred First Name on Name Tag *
Address *
City *
State *
Zip Code *
Best Contact Phone Number *
Alternate Contact Phone Number
Email Address *
Please use an email address that is checked often as a confirmation email will be sent to registered participants in July.
Workshop Accommodations Needed *
Educational Role *
School District or ESU with which you are employed *
Type N/A if not employed by a Nebraska K-12 entity.
Registration Fee *
Hotel Accommodations
If needed, hotel rooms will be available the evenings of July 17th and July 18th at the Holiday Inn Express & Suites (8801 Amber Hill Ct; Lincoln, NE 68526 - near 88th & Highway 2, Lincoln).  This hotel does provide a complimentary breakfast.  The regional programs will make hotel room reservations and pay for the rooms for participants employed in a Nebraska K-12 school district (participants’ travel time needs to be more than 2 hours in order to reserve a hotel room the night of July 17th).  Participants not employed in a K-12 Nebraska school district are responsible for making their own hotel and travel accommodations.  Please check below which nights you would like the regional programs to reserve a hotel room for you.  
Please check below which nights you would like the regional programs to reserve a hotel room for you. *
Name of Hotel Roommate Preference
Each hotel room will have two beds and be assigned two people.  If you would like a private room, you will be responsible for half of the room expense ($47.00 one night; $94 two nights - check made payable to ESU 9). Please type Private below if requesting a private room. If not requesting a private room and no roommate name is noted, a roommate will be assigned at will.
Clock Hours & CEUs
Participants will be awarded 12 clock-hour credits (in the "interpreting" category) for attending both days.  The Nebraska Regional Programs will not be awarding CEUs.  However, RID certified interpreters may still apply to receive CEUs on an individual basis if needed through a process called PINRA (Participant Initiated Non-RID Activity).  Participants must contact Traci Cooney at NCDHH prior to the workshop to complete a PINRA form (traci.cooney@nebraska.gov).  For Nebraska interpreter licensees, CEUs can be earned by providing a copy of the certificate of completion to Traci Cooney after the workshop.
Please contact your regional program coordinator prior to the workshop regarding other possible reimbursements such as mileage and meals.
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