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Self-Advocates of Michigan Virtual Community Conversation
1.
First Name
2.
Last Name
3.
Address
Address
Address 2
City/Town
State/Province
ZIP/Postal Code
Email Address
Phone Number
4.
Please indicate your ethnic/racial identity:
American Indian/Alaskan
Arab/Arab-American/Chaldean
Asian/Pacific Islander
African American/Black
Hispanic/Latino
White/Caucasian
5.
Please check which describes you:
A person with a disability
A family member of a person with a disability
A professional in the disability community
A business that provides services to people with disabilities
A person interested in disability issues
6.
Do you need any special accommodations to fully participate in the webinar?
ASL
CART Captioning Service
7.
What other subjects, or specific issues are you interested in learning about in future Community Conversations?
Current Progress,
0 of 14 answered
