2021-2022 ISHI Meeting Registration

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Complete this form if you plan to attend one or more ISHI Meetings during the 2020-2021 School Year. ISHI meetings are scheduled for:

- November 18, 2021, (format- in person/virtual: to be determined )
- March 3, 2022, (format- in person/virtual: to be determined )

Effective 2016-17 school year, ISHI Registration Dues are $100 per year. Registration dues can be paid by check, made out to ISHI.

Last Name *

First name *

School/Organization *

Title: *

Phone Number *

Email Address *

RSVP- March 3, 2022 *

I plan to attend the ISHI meeting on March 3, 2022 in person.

I plan to attend the ISHI meeting on March 3, 2022 virtually.

No I do not plan to attend the ISHI meeting on March 3, 2022.

Do you need an interpreter for the meeting on March 3rd?

Yes

Clear selection

Are you retiring soon?

I am retiring in Spring 2022

Clear selection

Please list any topics you wish to discuss with the group during our Hot Topics portion of the agenda. *

Do you have any questions or topics that you would like Amy Deegan (ISBE) to address during the meeting? *

Stacy will be presenting on updates in HAT systems and live voicing using the Roger device. Do you have any additional questions that you would like Stacy Michels (Phonak) to address during the meeting?

Hot Topic follow up for growing your own leader. In order to be a leader in your cooperative or district, what type of licensure is required?

Supervisory Endorsement

Principalship

Director of Special Education Certificate

Other:

Clear selection

Are you interested in becoming ISHI's next secretary? (It is really fun and you get to work with a great ISHI board!!) Or do you have anyone you would like to nominate?

Yes

Maybe

Other:

Clear selection

In person attendees: Please choose a lunch option. Options come with Chips, Fresh Fruit, a Cookie and a drink. $15/person, please bring a check or cash on 3/3. (Please list any allergies in the "other" section)

Option 1: Classic Club Croissant : Sliced Turkey and ham layered with Swiss and Cheddar Cheese, Tomato, Lettuce, and Applewood Bacon on a Flaky Croissant.

Option 2: Chicken Cesar Wrap: Chicken with fresh Lettuce and Tomato in a Whole Wheat Tortilla. Topped with Cesar Dressing.

Option 3: Vegan Option (Chef's Choice)

Option 4: Vegetarian Option (Chef's Choice)

I will bring my own lunch/I am attending virtually.

Other:

Clear selection

Registration Dues - $100 per year

After clicking submit below, you will receive a confirmation that your registration form has been received. Please print the page and keep it as a record of your registration. You may send payment to:
Jennifer Lindstrom
6020 West 151st Street
Oak Forrest, IL 60452

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