2016 Self-Advocate and Family Member Survey

The Wisconsin Board for People with Developmental Disabilities (BPDD) would like you to please take a few moments of your time to complete the 2016 Self-Advocacy Survey. This survey is for people with disabilities and family members who have participated in a BPDD project/activity (e.g., meeting, conference, community conversation) during the past year. Your feedback is very important to us! To thank you for completing the survey by Friday September 16th,, your name will be entered into a pool for a chance to receive a $50.00 gift card to Amazon!

If you have already completed this survey in the past year, please do not complete it again.

As a result of participating in a WI-BPDD project or activity during the past year...........

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1. I have:

Made more choices about my supports

Gotten more involved in my community

Increased my knowledge of resources to help me self-direct

Participated more in self-direction

Increased the number of people other than paid professionals, that support me

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2. I have increased my participation in:

Paid community employment

Looking for a paid community job

Efforts to increase community employment for people with disabilities

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3. I feel more confident that:

I can work in paid community employment

I know what resources I can use to help me get a job in the community

When I work in the community the business I work for is better

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4. I have increased my self-advocacy

Yes

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5. I am better able to say what I want

Yes

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6. I joined an advocacy group

Yes

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7. I had been participating in an advocacy effort prior to participating in a board activity

Yes

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8. I am now participating in a group advocacy effort

Yes

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9. I have increased my participation in a group advocacy effort

Yes

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10. I am now on a policy board, advisory board or governing body

Yes

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11. I am now in a leadership position for an organization

Yes

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12. I am more effective in my role serving on a board

Yes

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13. I am being paid for my role serving on a board

Yes

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14. Please tell us whether you are:

An individual with a disability

Family member of an individual with a disability

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15. Please tell us whether you are:

White

Black or African American

American Indian and Alaska Native

Hispanic/Latino

Asian

Native Hawaiian and other Pacific Islander

Two or more races

Race unknown

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16. During the past year which of the following BPDD projects/activities have you participated in?

Let's Get to Work

People First

SPARKS Grants

Partners in Policy Making

Employment First Partner Grants

Take Your Legislator to Work

Self-Determination Conference

Employment First Conference

Youth Leadership Forum

Budget Trainings

Advocacy Trainings

Disability Advocacy Day

Supported Decision Making

Building FULL Lives in the Community Grants

Family Led Project

Other (please specify)

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17. Were you satisfied with the BPDD project/activity that you participated in during the past year?

Yes

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18. Is your life better as a result of participating in a BPDD project/activity during the past year?

Yes

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19. Please share a story of how participating in WI-BPDD activities has made your life better.

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20. Please provide the following information (optional):

Name:

Address:

City/Town:

ZIP:

Email Address:

Phone Number:

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* 1. I have:

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* 2. I have increased my participation in:

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* 3. I feel more confident that:

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* 4. I have increased my self-advocacy

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* 5. I am better able to say what I want

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* 6. I joined an advocacy group

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* 7. I had been participating in an advocacy effort prior to participating in a board activity

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* 8. I am now participating in a group advocacy effort

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* 9. I have increased my participation in a group advocacy effort

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* 10. I am now on a policy board, advisory board or governing body

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* 11. I am now in a leadership position for an organization

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* 12. I am more effective in my role serving on a board

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* 13. I am being paid for my role serving on a board

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* 14. Please tell us whether you are:

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* 15. Please tell us whether you are:

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* 16. During the past year which of the following BPDD projects/activities have you participated in?

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* 17. Were you satisfied with the BPDD project/activity that you participated in during the past year?

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* 18. Is your life better as a result of participating in a BPDD project/activity during the past year?

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* 19. Please share a story of how participating in WI-BPDD activities has made your life better.

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* 20. Please provide the following information (optional):

1. I have:

2. I have increased my participation in:

3. I feel more confident that:

4. I have increased my self-advocacy

5. I am better able to say what I want

6. I joined an advocacy group

7. I had been participating in an advocacy effort prior to participating in a board activity

8. I am now participating in a group advocacy effort

9. I have increased my participation in a group advocacy effort

10. I am now on a policy board, advisory board or governing body

11. I am now in a leadership position for an organization

12. I am more effective in my role serving on a board

13. I am being paid for my role serving on a board

14. Please tell us whether you are:

15. Please tell us whether you are:

16. During the past year which of the following BPDD projects/activities have you participated in?

17. Were you satisfied with the BPDD project/activity that you participated in during the past year?

18. Is your life better as a result of participating in a BPDD project/activity during the past year?

19. Please share a story of how participating in WI-BPDD activities has made your life better.

20. Please provide the following information (optional):