1.Which National Service program are you currently serving with?
(Please read all options carefully).

AmeriCorps VISTA

AmeriCorps Seniors (Foster Grandparents, RSVP, or Senior Companions)

National Direct (MT Conservation Corps, JVC Northwest)

AgCorps

Big Sky Watershed Corps

Community Health Corps Montana

Fish, Wildlife, and Parks AmeriCorps

Justice for Montanans

Other (please specify)

2.Are you a:

First year member

Second year member

Third year/plus member

Prefer not to disclose

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

*Reasonable Accommodation is any change in the service environment or in the way things are customarily done that enables an individual with a disability to enjoy equal service opportunities.

Reasonable accommodation must be feasible or plausible for the program and/or service location, and enable the individual to perform the essential functions of a position.

Examples include auxiliary aids/services, CCTV, an amplified audio listening device, a sign language interpreter, materials on audio tape, enlarged text documents, or adjusted service schedules.(Required.)

Yes

No

*4.Do you consider yourself to be a person with a disability*? If you answer no, you will be directed to the end of the survey.

*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(Required.)

Yes

No