The code block below illustrates how one might use # and // as comments in your logic and calculations.

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The value you provided must be within the suggested range

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This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

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The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

SUMMER SECONDARY TRANSITION MINI-CONFERENCE

The Arc Tennessee’s Summer Secondary Transition Mini-Conference will cover topics of interest to families and students as they make the transition from school to adult life, including, the Secondary Transition Plan, Adult Services, Vocational Rehabilitation, Self-Advocacy and Alternatives to Conservatorship and Conservatorship.

Registration is $25.00 per person and includes a box lunch, snacks, bottled water and training materials.

First Name

* must provide value

Last Name

* must provide value

Company/Affiliation

Mailing Address

* must provide value

City

* must provide value

State

* must provide value

Zip Code

* must provide value

Best Contact Phone Number

* must provide value

Email Address

Special Accommodations:

None Needed

Noted Below

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Special Accommodation Needed:

Dietary Needs/Restrictions

No Restrictions

Needs/Restrictions noted below

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Dietary Needs

Food Allergies:

Payment Via:

Credit Card ~ Processed online and onsite
Check ~ Payable at the Door ONLY

Visa/MC/Discover

Check

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Credit Card Number

Credit cards are processed manually after your registration is received. You will be emailed a receipt.

Name on Credit Card

Expiration Date

Verification Code

Billing Address for Credit Card - if different from above

Billing Zip Code for Credit Card - if different from above

I live in the following geographical area

Rural

Urban

I am

Male

Female

Race/Ethnicity

White, alone

Black or African American

American Indian and Alaska Native alone

Hispanic/Latino

Asian alone

Native Hawaiian & Other Pacific Islander

Two or more races

Race unknown

I identify myself as a:

Person with a disability

Family member

Professional in the field

Interested citizen

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