OCALI Lending Library - OST Practice Braille Test Evaluation

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* 1. Patron Name

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* 2. Email Address

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* 3. Are you a person with a disability?

Yes

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* 4. Are you a family member of a person with a disability?

Yes

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* 5. Title/Role

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* 6. OST Grade Level or End of Course Exam Content Area:

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* 7. Accession Number

Refer to the email you received regarding taking the survey to find the accession number of item borrowed. You can also look for the eight digit number associated with the item on top or side of the container that the items were packaged in.

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* 8. Date Requested

Please enter the date you requested the item below:

Date

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* 9. Date Received

Please enter the date you received the requested item below:

Date

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* 10. County

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* 11. Zip Code

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* 12. School District or Organization

If you work for a school, please enter the name of the district that your school belongs to. If you do not work for a school, please simply enter the name of the organization that you work for.

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* 13. If your student(s) qualify for special education, please select the disability category: (check all that apply)

Autism spectrum disorder (ASD)

Deafness

Deaf-blindness

Emotional disturbance

Hearing impairment

Intellectual disability

Multiple disabilities

Other health impairment

Orthopedic impairment

Specific learning disability (SLD)

Speech or language impairment

Traumatic brain injury

Visual impairment, including blindness

OCALI Lending Library - OST Practice Braille Test Evaluation

Question Title

* 1. Patron Name

Question Title

* 2. Email Address

Question Title

* 3. Are you a person with a disability?

Question Title

* 4. Are you a family member of a person with a disability?

Question Title

* 5. Title/Role

Question Title

* 6. OST Grade Level or End of Course Exam Content Area:

Question Title

* 7. Accession Number

Refer to the email you received regarding taking the survey to find the accession number of item borrowed. You can also look for the eight digit number associated with the item on top or side of the container that the items were packaged in.

Question Title

* 8. Date Requested

Question Title

* 9. Date Received

Question Title

* 10. County

Question Title

* 11. Zip Code

Question Title

* 12. School District or Organization

If you work for a school, please enter the name of the district that your school belongs to. If you do not work for a school, please simply enter the name of the organization that you work for.

Question Title

* 13. If your student(s) qualify for special education, please select the disability category: (check all that apply)

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* 14. How many individuals used the practice test?

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* 15. Other comments or technical issues that need our attention (repair, missing components, items not working):

OCALI Lending Library - OST Practice Braille Test Evaluation

Question Title

* 1. Patron Name

Question Title

* 2. Email Address

Question Title

* 3. Are you a person with a disability?

Question Title

* 4. Are you a family member of a person with a disability?

Question Title

* 5. Title/Role

Question Title

* 6. OST Grade Level or End of Course Exam Content Area:

Question Title

* 7. Accession NumberRefer to the email you received regarding taking the survey to find the accession number of item borrowed. You can also look for the eight digit number associated with the item on top or side of the container that the items were packaged in.

Question Title

* 8. Date Requested

Question Title

* 9. Date Received

Question Title

* 10. County

Question Title

* 11. Zip Code

Question Title

* 12. School District or OrganizationIf you work for a school, please enter the name of the district that your school belongs to. If you do not work for a school, please simply enter the name of the organization that you work for.

Question Title

* 13. If your student(s) qualify for special education, please select the disability category: (check all that apply)

Question Title

* 14. How many individuals used the practice test?

Question Title

* 15. Other comments or technical issues that need our attention (repair, missing components, items not working):

* 7. Accession Number

Refer to the email you received regarding taking the survey to find the accession number of item borrowed. You can also look for the eight digit number associated with the item on top or side of the container that the items were packaged in.

* 12. School District or Organization

If you work for a school, please enter the name of the district that your school belongs to. If you do not work for a school, please simply enter the name of the organization that you work for.