Power In Our Voices - Literacy session - 11-04-26 - Registration

Please be advised that the Developmental Disabilities Council will photograph and/or record video and/or audio at our event. Speakers, attendees, guests, and all others present may be photographed. By registering for and attending this event, you acknowledge that you have been informed that you may be photographed, video recorded, and/or filmed. You grant the DDC permission, without further notification, to publish photographs and video taken of you and containing your image/likeness for publicity, general information purposes, social media platforms, press releases, etc. If you do not wish to be photographed or videotaped, please notify the photographers or videographers if they approach you. Please note all reasonable accommodation requests must be received one week prior to the event date to ensure adequate time to reserve services.

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1. Name: (Required.)

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2. Email: (Required.)

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3. Phone (optional):

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4. Do you have any dietary restrictions or specific dietary needs? Please specify. (Required.)

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5. Please select the category that best identifies you. (Required.)

Person with a disability

Parent or Family Member of a person with a disability

Professional

Other

None of the above

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6. Please choose which best describes you.

American Indian or Alaska Native

Asian or Asian American

Black or African American

Hispanic or Latino

Middle Eastern or North African

Native Hawaiian or other Pacific Islander

White

Another race

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7. Please choose the best that identified you. (Required.)

Female

Male

Prefer not to answer

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8. What County do you live in? (Required.)

New Castle County

Kent County

Sussex County

Do not live in Delaware

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9. Are there any other reasonable accommodations you may require? ( sign language interpretation or language interpretation). Please specify. All reasonable accommodation requests must be received one week prior to the event to ensure adequate time to reserve services. Please note that the DDC staff can arrange event accessibility accommodations but cannot provide personal care or individualized direct support services, such as feeding, toileting, transferring, medication assistance, or continuous one-to-one assistance. If you require personal assistance during the event, please plan to attend with your PCA, DSP, caregiver, family member, or other support person. Please make sure you and your support person both register for the event so that we may plan for the event accordingly. (Required.)

Power In Our Voices - Literacy session - 11-04-26 - Registration

Question Title

* 1. Name: (Required.)

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* 2. Email: (Required.)

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* 3. Phone (optional):

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* 4. Do you have any dietary restrictions or specific dietary needs? Please specify. (Required.)

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* 5. Please select the category that best identifies you. (Required.)

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* 6. Please choose which best describes you.

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* 7. Please choose the best that identified you. (Required.)

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* 8. What County do you live in? (Required.)

Question Title

1. Name: (Required.)

2. Email: (Required.)

3. Phone (optional):

4. Do you have any dietary restrictions or specific dietary needs? Please specify. (Required.)

5. Please select the category that best identifies you. (Required.)

6. Please choose which best describes you.

7. Please choose the best that identified you. (Required.)

8. What County do you live in? (Required.)