Gravity Form to e-signature-International Workshops (Addendum) Today's Date0303123456789101112202012345678910111213141516171819202122232425262728293031202520252024202520262027ORIGINAL Contract Date(Required) MM slash DD slash YYYY Workshop Partner Full Name (First Name and Last Name)(Required)Workshop Partner Organizaton(Required)Workshop Partner email(Required) Workshop Course(Required) Level 1: Three Part Treatment Plan for OPT Level 2: OPT: Assessment and Program Plan Development Level 4 (Note: there is an addendum for this course and will be sent after this agreement is signed) Level 3 (Note: there is an addendum for this course and will be sent after this agreement is signed) Differential Diagnosis: Childhood Apraxia of Speech Feeding Therapy: A Sensory-Motor Approach Functional Assessment and Treatment of TOTs (Tethered Oral Tissues) Taking Your Client with Autism from Non-Vocal to Verbal Other Workshop Instructor(Required) Vanessa Anderson Smith Line Avers Lori Overland Monica Purdy Renee Roy Hill Rehab Zaytoun ORIGINAL Start Date(Required)MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear2024202520262027ORIGINAL End Date(Required)MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear2024202520262027NEW Start Date(Required)MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear2024202520262027NEW End Date(Required)MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear2024202520262027
