Paul V. Sherlock Center on Disabilities

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Sentinel Project

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Name*

Address*

City*    State    Zip Code*

Phone Number home  work   cell

Email

Best way to contact you is: Phone   Email

Best time to contact you is: Morning  Afternoon   Evening

Are you.....(check all that apply)
Person with a Disability   Family member of a person with a disability Are you a member of....(check all that apply)

RI Developmental Disability Council

RI Department for Youth and Families

another state agency
Name of agency

a parent training organization
Name of organization (RI Parent Information Network Parent Support Network, etc.)

a self advocacy organization
Name of organization (PAL, Advocates in Action, etc.)

other community organization concerned with the welfare of individuals with disabilities and their families
Name of organization

*required

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Email Jenny

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Projects & Services   | Dual Sensory Impairment Program | Early Intervention | Educational Advocates Program | Employment Supports | Family Support 360 Transition to Adult Life | Local 360 Supportive Parenting Project | RI Vision Education & Services Program | RI State Improvement Grant | School Wide PBIS | Sentinel Project | Teacher Recruitment
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Questions/Comments contact Mary Anne Pallack | Rhode Island College | ©2008 Sherlock Center on Disabilities