Getting to know you Survey

1.Please share your name and contact information, including email. Your information will not be shared with anyone outside the leadership of Alabama Hands & Voices.

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

2.What is your role? Are you a parent, professional or Deaf/Hard of Hearing adult from Alabama? Please select all that apply.

Parent

Professional

Deaf/Hard of Hearing Adult

3.If you are a professional who works with Deaf and Hard of Hearing children, what is your role?

N/A

Please share your role.

4.What are your hopes for an Alabama chapter of Hands & Voices?

5.What are your needs, regarding Deaf and Hard of Hearing children in Alabama?

Language

Technology

Education

Advocacy

Other (please specify)

6.Which of the following areas interest you. Please select all that apply.

Parent to parent mentoring

Mentoring from a Deaf or Hard of Hearing adult.

Parent education-Please specify areas of interest and whether you're interested in a virtual or in-person attendance.

Online chat groups, such as Facebook chats or zoom meeting. What time of day and topics would you like to have covered?

Social activities for families. Please let us know your city and type of activity.

Other (please specify)

7.Any comments?