OUTniagara Accessibility Supports Request Form

This form is to be used to request accessibility supports available in order to attend an OUTniagara event or workshop. Types of supports include reimbursements and transit tickets, depending on the type requests are indicated.

This form must be submitted to OUTniagara a minimum of 12 hours prior to the start of the event or workshop. Upon internal review and confirmation of your request, you will receive an email from the team at OUTniagara to confirm your request has been process and approved. Relevant access supports will be provided at the event or following, depending on the type of access request.

If you have submitted a request and it was approved, but you are unable to attend the event or workshop, you will not receive the accessibility support requested.

If you have any questions about this process, please email kerry@outniagara.ca.

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* 1. Name

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* 2. Pronouns (e.g. they/ them, she/her, he/him, ze/zir, they/them, she/they, etc.)

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* 3. Contact information

Email Address

Phone Number

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* 4. Please list the name and date of the OUTniagara event/ workshop are you attending that applies to this reimbursement.

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* 5. What type of accessibility supports are you requesting?

Large print handouts (18 point sized font and above)

Childcare/ dependent care reimbursement ($40 per event)

2 Municipal Public Transit Tickets

2 Municipal Paratransit Tickets

2 Niagara Regional Public Transit Tickets

2 Niagara Regional Specialized Transit Tickets

Taxi service reimbursement up to a maximum of $35 (must be organized by the participant, and proof of payment must be submitted at the event or within 48 hours of the event)

Language Interpretation/ Translation - including sign language - (must be organized by the participant, and an invoice and proof of payment must be submitted at the event or within 48 hours of the event)

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* 6. If you selected any of the municipal transit options above, please list the name of the Niagara-based municipality you transit tickets for.

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* 7. If there is an accessibility need not listed above that you require in order to attend the OUTniagara event or workshop you indicated above, please list this need and we will follow up with you via email to let you know if we can fulfill this request.