Application Deadline: December 31, 2020 All meetings will be virtual. Equipment and assistance is available from library staff if required. Application 1 Start 2 Complete 1. First Name * Last Name * 2. Preferred Name 3. Preferred Personal Pronoun She He They Other 4. Street Address * Address Line 2 City, Province, Postal Code * 5. Phone 6. Email 7. How would you like us to contact you if you are selected for an interview? Email Phone Voice/TTY 8. How did you hear about the Accessibility Advisory Committee? Friend Organization Social Media Library website Advertisement Other Interest 9. Why are you interested in participating in this committee? 10. What do you hope you can put in motion as a member of this committee? Experience 11. My experience is best described as: Lived experience Experience as an advocate for a friend or loved one Work experience with an accessibility-related group or organization Other 12. a) Are you a person who lives with a disability or impairment? * Yes No 12. b) If yes, under which category does your disability fit? Please check all that apply. Mobility and Physical Intellectual or Learning Psychiatric Visual Hearing Neurological Other 13. a) Are you a member or employee of an organization representing people with disabilities? * Yes No 13. b) if yes, which organization: 14. a) Do you have experience working with people of varying abilities? Yes No 14. b) if yes, will you please share one example of where you worked or volunteered and briefly outline your role and responsibilities? 15. a) Do you have experience serving on a board or advisory committee? Yes No 15. b) If yes, please describe your experience serving on a board or advisory committee. 16. Please indicate which of the following areas you have knowledge and understanding of, as they relate to accessibility and accessible practices: Please select all that apply. Built environment Education Employment Goods and services Information and communication Transportation Availability -- 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. 17. Are you able to commit to attending 4-5 meetings per year? * Yes No Submit
