2017 On Eagles Wings Application
1. Are you African American: Yes No
2. Are you interested in gaining a basic understanding of leadership skills and best practice in the field of developmental disabilities? Yes No
3. Are you an adult with a disability? Yes No
4. Do you have child or children with developmental disabilities Yes No
5. What services do you or your eligible child/children with DD receive : _______________________________________
1. Do you are your eligible child/children with DD receive waivered services? Yes No
2. Do you or your child/children receive PCA services? Yes No
3. Do you or your children receive Day Treatment & Training? Yes No
1. How old were you or your eligible child/children with DD when they started special education services? ______________ Yrs.
2. Are you looking for special education services for your eligible child/children with DD? Yes No
3. Does your eligible child/children with DD have challenging behavior? Yes No
Tell Me Something About Yourself:______________________________________________________________________________________________________
Call Julie Kenney at 612.816.9648 [cell phone you can also text me at this number] if you have any questions or e-mail her at Julie.email@example.com
On Eagles Wings
On Eagles Wings Training
Where: University of Minnesota Urban Research and Outreach-Engagement Center [UROC]
When: 1st Saturday, January 21st;
Time: All training will be from 8:30 am to 2:00 pm
Supports: No Stipends. Participants without children will not receive childcare reimbursement
Mail this application to: Julie Kenney 6611 Lynwood Blvd. Richfield, MN 55423 or email me this application to Julie.Kenneyipsiiinc@gmail.com or text your application to Julie Kenney at 612.816.9648
On Eagles Wings is an IPSII Inc. project funded by the MN Governor’s Council on Developmental Disabilities through Administration on Developmental Disabilities P.L.106-402 and IPSII Inc.
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