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Restrictions

All services are free
Confirmations for Maryland applications will be sent within fourteen (14) business days.
Confirmations for out-of-state applications will be sent pending consideration.

 

Agency Name
Address
Contact Person
Email Address
Phone Number     Fax Number  
Location of Presentation
(if different from address above)
Address

Audience
Professional Outreach 
Community Outreach
One-on-One Education
 
Expected Attendance
individuals

Schedule

Please provide three best times for this outreach (dates and times)

Communication Method Preferred
Audiologically-oriented (oral, speech reading)
Visually-oriented (sign language, gestures)
Audiovisually-oriented (speaker with interpreter)
 
Audience Literacy (check all that apply)
College (post secondary)
High School (secondary)
Developmentally Disabled
Minimal Language Skills (MLS)

Comments

Family Service Foundation Maryland AIDS Administration

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