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PREA Summit Registration

Please complete the registration form for the PREA Summit. There is no registration fee for this training. If you have any questions, please contact Josh Keehne, Training & Technical Assistance Coordinator, at josh@ccasa.org.

* indicates required field

First Name:*

Last Name:*

Agency/Affiliation:*

Title/Position:*

Email:*

Address:*

Phone:*

Day(s) Attending

Please indicate which day(s) you are registering for:*

Day 1 - May 15 - open to ADVOCATES only
Day 2 - May 16 - open to corrections staff AND advocates

Travel Scholarships

If you are requesting a travel scholarship, please check all that apply:

mileage
lodging for 1 night
lodging for 2 nights
lodging for 3 nights

Media Release

Please check the box if you do NOT want to be included in photos we may use on social media and in other communications.

Accessibility Needs

We value access and safety and strive to make our meetings accessible and welcoming to all participants. For example, we have selected a hotel with a commitment to access, meeting room and areas will be set to allow for maximum space and access, all faculty have been provided with guidance on making their presentations accessible, and all meeting materials are provided in 14 point font. We also provide auxiliary aids and services to meet the individual needs of those attending the meeting. Please select any accessibility accommodation(s) you require for the meeting below. If your accommodation is not listed, please request it by here. Please contact Agueda Morgan at agueda@ccasa.org with any questions or for more assistance.

Lodging Accommodation

You are responsible for making your own hotel reservation. However, by providing us with information on the type of room you need, we will be able to check with the hotel to make sure they meet your room request.

Please indicate which room type you require from the following list:

ADA Room with Roll-in Shower
ADA Room with Tub & Chair
Room Accessible for Deaf/Hard of Hearing
Chemical Free Room

Alternate Format

If you are a person with a disability and require materials in an alternate format for access, please select from the following formats:

Electronic copies of materials in advance
Electronic text file of materials on-site
Hard Copies of materials on-site
Materials in Braille
Materials in Plain Language
Materials in Simple Language
Materials in font over 14pt, please specify above

Interpretation

Please indicate any interpreting needs from the list below:

American Sign Language
CART
Cued Speech
Simultaneous Communication
C-Print
Simultaneous Spoken Foreign Language Interpretation: Please Specify language in "Other" if needed
Signed English

Support Services

If you are traveling with a personal care attendant, personal assistant, or other support services, please list their name(s) here:

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Who We Are

The Colorado Coalition Against Sexual Assault is a statewide organization that provides leadership, advocacy, and support to address and prevent sexual violence.

Contact Us

1330 Fox Street, Suite 2
PO Box 40350
Denver, CO 80204

Phone: 303.839.9999

Email: info@ccasa.org

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Copyright 2011-2019 CCASA

Contacting the Colorado Coalition Against Sexual Assault or any individuals in our organization in no way constitutes a "client/agency" relationship. The purpose of this website is to provide education and resources on issues of sexual violence; we make every effort to keep the most current information available on this site but do not warrant the accuracy or usability of this information. The Colorado Coalition Against Sexual Assault is not a direct service organization.