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* 1. Which National Service program are you currently serving with?

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* 2. Are you a:

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* 3. What city or region is your primary service location?

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* 4. When you applied to serve in your program were you aware of the availability of reasonable accommodations?

*Reasonable Accommodation is any change in the work environment or in the way things are customarily done that enables an individual with a disability to enjoy equal employment opportunities. A reasonable accommodation must be feasible or plausible for the employer and must enable the individual to perform the essential functions of a position.

Reasonable accommodation examples include auxiliary aids/services, CCTV, an amplified audio listening device, a sign language interpreter, materials on audio tape, enlarged text documents, or adjusted work schedules.

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* 5. Do you consider yourself to be a person with a disability?  (The Americans with Disabilities Act defines disability as a physical or mental impairment that substantially limits one or more major life activities of an individual, a record of such an impairment, or being regarded as having such an impairment. For more definitions, visit: www.ada.gov)

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* 6. Please check any of the following conditions that substantially limit one or more of your major life activities, if you have a record of, or are regarded as having such impairment. Definitions at:  https://www.ssa.gov/disability/professionals/bluebook/AdultListings.htm

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* 7. Have you disclosed a disability to any staff persons in your organization? *Disclosure can happen in a number of ways, from an informal conversation to a formal, written request for an accommodation. It can happen at any time during the term of service, but it should occur as soon as a person realizes they may need an accommodation.

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* 8. If you have a disability, have you requested a reasonable accommodation for your term of service?

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* 9. If you requested a reasonable accommodation was it provided by the program?

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* 10. If provided, did the reasonable accommodation allow you to fully participate in the program?

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* 11. Are you interested in learning more about disability inclusion?

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* 12. If yes, what topics are of most interest to you?

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* 13. Thank you for completing this survey! For more information, visit www.ada.gov and www.eeoc.gov. 
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