WSDOT Active Transportation Plan Request for Presentation or Materials

Use this form to let us know about opportunities to spread the word about the 2019 State Active Transportation Plan.

- Tell us about an upcoming event, meeting, or other gathering where you would like to have someone present information.

- Let us know if you would like to become an Active Community Ambassador to help your family, friends, and neighbors share their priorities.

- Request electronic files for materials to hand out and share in social media.

- Tell us where you could put up flyers or posters.

Americans with Disabilities Act (ADA) Notice to Public
This questionnaire can be made available in an alternate format by emailing the WSDOT Diversity/ADA Affairs team at wsdotada@wsdot.wa.gov or by calling toll free, 855-362-4ADA (4232). Persons who are deaf or hard of hearing may make a request by calling the Washington State Relay at 711.

Información del Acta (ADA) de Estadounidense con Discapacidad
Este material se puede hacer disponible en un formato alternativo o traducción al español por correo electrónico al equipo de Asuntos de diversidad/ADA WSDOT en wsdotada@wsdot.wa.gov o llamando gratis, 855-362-4ADA (4232). Personas sordas o con problemas de audición pueden solicitar llamando el relé de estado de Washington al 711.

Question Title

* 1. Your contact information. We need to be able to get in touch to confirm or clarify information you submit.

First name

Last name

City/Town

ZIP/Postal Code

Email Address

Phone Number

Question Title

* 2. Event information (any type of event: meetings, community events, other). Provide as much information as you can. Be sure to include contact information so we can follow up. We'd like to have contact information for someone with the entity whose event this is.

Date

Start and end times

Address/location

City where it will be held

Whose event is this? (Name of organization, group, other hosting entity or agency)

Type of event or meeting

First name of event contact if not you

Last name of event contact

Email address for event contact

Phone number for event contact

What's the opportunity or invitation? (Event speaker; webinar presentation; have an information table; other)

Expected number of people in attendance (it's fine to guess)

Audience description

If you're requesting a presentation, would it be possible for it to be delivered via webinar or video connection if that's the only way someone can be available to speak?

Question Title

* 3. What else should we know to help us determine if/how we can participate in the event opportunity described above?
Is this a SUGGESTION or a CONFIRMED INVITATION to participate as described above?

Question Title

* 4. We will be providing all toolkit materials in English and Spanish, with other translation needs to be determined. What other language(s), if any, would be most useful for translation of materials?

Question Title

* 5. Will people attending the event or receiving materials you will distribute need them in an alternate format to be accessible to those with disabilities, as far as you know?

Question Title

* 6. Tell us how you want to be involved in spreading the word about the State Active Transportation Plan.

I'll make copies of the materials and hand them out at events and meetings in my area (we will send you electronic files)

I'll print and put up flyers or posters in public places in my area (libraries, transit center, etc.) (we will send you electronic files)

I'm interested in participating in a webinar about becoming an Active Community Ambassador and presenting on the ATP in my community

I'll share items through email and/or social media channels (we will send you electronic files)

Comments and your ideas not listed above for how you can help spread the word so people know about the plan, take the survey, and get involved.

WSDOT Active Transportation Plan Request for Presentation or Materials

Question Title

* 1. Your contact information. We need to be able to get in touch to confirm or clarify information you submit.

Question Title

* 2. Event information (any type of event: meetings, community events, other). Provide as much information as you can. Be sure to include contact information so we can follow up. We'd like to have contact information for someone with the entity whose event this is.

Question Title

* 3. What else should we know to help us determine if/how we can participate in the event opportunity described above? Is this a SUGGESTION or a CONFIRMED INVITATION to participate as described above?

Question Title

* 4. We will be providing all toolkit materials in English and Spanish, with other translation needs to be determined. What other language(s), if any, would be most useful for translation of materials?

Question Title

* 5. Will people attending the event or receiving materials you will distribute need them in an alternate format to be accessible to those with disabilities, as far as you know?

Question Title

* 6. Tell us how you want to be involved in spreading the word about the State Active Transportation Plan.

* 3. What else should we know to help us determine if/how we can participate in the event opportunity described above?
Is this a SUGGESTION or a CONFIRMED INVITATION to participate as described above?