RIT - NTID - Steps to Success

Registration deadline: June 15, 2009

1) Basic

Student Information

Student's Name
Date of Birth	/ /
Gender	Male Female
Home Address
City
State
Zip
Phone Number	Voice TTY
Cell/Pager
Email Address
Who will come with you?	Parent Guardian Teacher Someone Else No one will be coming with me
Name of the person or people coming with you

School Information

School Name
Address
City
State
Zip
Your current grade in school	6th 7th 8th
Teacher's Name
Teacher's Phone	Voice TTY
Fax
Teacher's E-mail

Parent/Guardian/Teacher/Adult Information

Parent/Guardian's Name
Home Address
City
State
Zip
Home Phone	Voice TTY
Work Phone	Voice TTY
Fax
Cell/Pager
Parent/Guardian's E-mail
What language does your family use to conduct daily activities? English American Sign Language Other:
We plan a walking tour of campus. Do you or does anyone who will be attending have a disability that requires special assistance? Yes No If yes, what does he/she need?

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