Skip to content
Mindful Decomissioning Accommodation Survey
Register
Great! We are excited to see you on Zoom on October 2, 2024 from 6-8 pm. Please register by completing the information below.
*
1.
Please complete the information below to register for the workshop
(Required.)
Name
Email
Zip code
2.
How will you participate in the workshop?
From my computer
From my phone
Another way
Other (please specify)
3.
Will you need interpretation services in the workshop? If so, which language(s)?
No
Yes, please specify what language you need interpretation in:
4.
Will you need translation of the outreach materials? If so, which language(s)?
No
Yes, I will need translation materials in ____ language.
5.
Will you require materials to be accessible for disability needs? If so, please describe the need.
No
Yes, please describe how we can support you.
6.
Would you prefer the workshop to include closed captioning?
Yes
No
7.
What additional accommodations will you require to actively and meaningfully participate in the workshop?
8.
Are you affiliated with a community-based organization?
No
Yes, please speficy:
