Report an Accessibility / Accessibility Feedback Form

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* 1. Name (Optional)

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* 2. If applicable, please provide the date an accessibility barrier was experienced.

Date / Time

Date

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* 3. At which SD10 school or facility was the barrier experienced?

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* 4. Please describe the barrier, including what you or someone you know was trying to access or use?

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* 5. Do you have recommendations that would mitigate or eliminate the experience of this accessibility barrier?

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* 6. Do you have other feedback including concerns, considerations or recommendations as relate to accessibility in SD10?

If you wish to have someone follow up with you regarding your comments or concerns, please complete the following contact information questions.

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* 7. Email Address (Optional)

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* 8. Phone Number (Optional)

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* 9. What is your preferred method for follow up communication?

Phone

Email

In Person