Library Accessibility Committee Application Form
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Library Accessibility Committee Application Form
Name
First
(Required)
Last
(Required)
Preferred Name
Preferred Pronoun
She
He
They
Other
Email
(Required)
Phone
How would you like us to contact you if you are selected for an interview?
Email
Phone
Voice/TTY
Address
Street Address
Address Line 2
City
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Province
Postal Code
How did you hear about the Advisory Committee?
Friend
Organization
Social Media
Library website
Advertisement
Other
Why are you interested in participating in this committee?
What do you hope you can put in motion as a member of this committee?
(Required)
My experience is best described as:
(Required)
Lived Experience
Experience as an advocate for a friend or loved one
Work experience with an accessibility-related group or organization
Are you a person who lives with a disability?
(Required)
Yes
No
If yes, under which category does your disability fit?
(Required)
Please select all that apply.
Hearing
Intellectual or Learning
Mobility and Physical
Neurological
Psychiatric
Visual
Other
Are you a member or employee of an organization representing people with disabilities?
(Required)
Yes
No
If yes, which organization?
(Required)
Do you have experience working with people of varying abilities?
(Required)
Yes
No
If yes, will you please share one example of where you worked or volunteered and briefly outline your role and responsibilities.
(Required)
Do you have experience serving on a board or advisory committee?
(Required)
Yes
No
If yes, please describe your experience serving on a board or advisory committee.
(Required)
Please indicate which of the following areas you have knowledge an understanding of, as they relate to accessibility and accessible practices.
(Required)
Please select all that apply.
Built environment
Education
Employment
Goods and services
Information and communications
Transportation
The Library will work with successful applicants to determine the most suitable times and locations for Accessibility Advisory Committee meetings. Members of this committee must be able to commit to approximately 3 hours of volunteer time per meeting, 4-5 times per year.
(Required)
Yes
No
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