People with Disabilities Awareness Day 2012

Guest Registration

Tuesday, April 17, 2012
State Capitol
Noon to 4:30 p.m.

If you have questions, call 405.951.3478 or 800.845.8476 or email sburton@okdrs.gov.

First Name:        Last Name:

Home Address:

City:        , State:        Zip:

Phone:

Email:

Would you like to be added to our email list to receive DRS information in the future? Yes No

Which format do you need print material in? Standard Print Large Print Braille

Are you a DRS employee? We welcome everyone and would like to know how many join us
from outside the agency. Yes No

Please fill in this box with a note to your legislators about your concerns or ideas regarding disabilities that we will distribute for you in advance or you may get a card at registration to fill out and deliver your note personally.

For security purposes please enter "1939" in the box below:

People with Disabilities Awareness Day 2012

Guest Registration Tuesday, April 17, 2012 State Capitol Noon to 4:30 p.m.

Guest Registration

Tuesday, April 17, 2012
State Capitol
Noon to 4:30 p.m.