Yes! I want our organization to become a member of the Oregon Network, a collaborative statewide network of disability organizations and their members, including people with disabilities, their families, friends, providers, and policymakers. Members of the Oregon Network share information with one another, receive Oregon Perspectives and other publications, can learn about training events and empowerment opportunities, and have the chance to voice opinions on policy issues at the local, state and national level. Please complete all information:

Organization Name: Organization Address: City: County: State: Zip: Organization Phone:   INCLUDE AREA CODE Organization Fax:   INCLUDE AREA CODE Organization Website Address: Contact Person's Name: Contact Person's Phone:   INCLUDE AREA CODE AND EXTENSION Contact Person's E-mail: What is the best way to reach the Contact Person with timely information? Email Fax Phone   I am most interested in the following topics: Assistive Technology Brokerage Services Child Care Early Intervention/Early Childhood Special Ed Employment Family Advocacy Family Support Health Care Housing Recreation Residential Supports Respite Care Self Advocacy Special Education Transition from School Transportation I am most concerned with issues* related to: Autism Blind/Visual Impairments Brain Injuries Cerebral Palsy Cognitive Disabilities Communication Disorders/Speech/Language Impairments Deaf/Hearing Impairment Developmental Disabilities Emotional Disabilities Genetic/Rare Disorders Learning Disabilities Mental Health Mental Retardation Physical Disabilities *Conditions listed are NOT intended as labels for individuals. Please send me the following publications of the Oregon Council on Developmental Disabilities: Oregon Perspectives The People First Connection