# Sample DoForm Configuration File
# 
# Medialab Application - 07/13/00
# 


MAIL-TO dickenke@jmu.edu Applicant |||Name^20|||
+--------------------------------------------------+
||               T/TAC Request-form                 ||
||                       from                       ||
|||Name^50|||
||                        at                        ||
+--------------------------------------------------+
Name: |name|
School_Agency: |school|
Address: |address|
City: |city|
State: |state|
ZipCode: |zipcode|
Phone: |phone|
Email: |email|

School District/EIA/SOP: |division|

Title: |title|

Program Affiliation:
|early_child_special_ed|
|early_interv|
|general_edu|
|school_age_spe|
|adult_edu|
|even_sta|
|head_sta|
|homeless|
|migrant_edu|
|occ_childcare|
|preschool_init|
|title|     
|other|

Disability Descriptions:
|d_add|
|d_autism|
|d_blind|
|d_deafn|
|d_d_delay|
|d_emo_dist|
|d_h_impair|
|d_l_disa|
|d_ml_retard|
|d_m_disabi|
|d_o_impai|
|d_ot_h_imp|
|d_se_dis|
|d_spe_imp|
|d_t_b_inj|
|d_vi_imp|

Training Registration for:
|training4|
|training12|
|training17|