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Starnet Professional Development Assistance Application Form

NAME- & Telephone Number*

Answer Required

Email:*

Answer Required

Please complete the form below. Required fields marked with an asterisk *

*For Early Childhood Special Education Professionals*

Answer Required

Educator

Therapist

Support Staff

Assistant

Administrator

School Name:*

Answer Required

What event do you plan on attending? Include date and location*

Answer Required

(preference is given to in - state events)

Projected Expenses:

Answer Required

SUBSTITUTE FUNDING REQUEST ONLY ($200 Maximum for families/$150 Maximum for Professionals)
I am submitting this application for pre-approval.
Preference is given to families with children under the age of 6 years old. Professionals working with children 3-5 with special needs in classroom or school settings, and in state events.
I understand my application is subject to review.

Clerk's Name & Telephone*

Answer Required

Clerks Email Address*

Answer Required