Join the Collab today!
Disability Lead is seeking to build an engaged community space, the Collab, that represents an intersectional approach to racial equity and disability justice to intersect. In other words, people will be able to show up for the disability community, and the disability community will be able to show up for racial justice. Our Collab will hold space consistently as a group to exchange ideas and support around shared values and goals for people in the Chicago region who are active or want to be active in disability rights and racial equity. Community members will connect, collaborate, socialize, coordinate project work, share resources, and best practices, and benefit from the momentum and inspiration of the shared space. If you would like to engage in this meaningful and necessary work, please complete this signup form and let us know why now is the time for you to join this community.
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Registration Information
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Mailing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Organization (if you are representing one)
Title
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Voluntary Self Disclosure
Why are we asking questions about gender, sexual orientation, disability, race and ethnicity, and veteran status? Disability Lead seeks to collect a variety of demographic information about our community members. Your response will not influence a decision regarding acceptance and will only be used to help measure our success in attracting a diverse pool. While we annually review and revise this section based on user feedback to include diverse response options, we would like to acknowledge that this system is imperfect. We recognize the limitations of the response options provided and value the opportunity for all members to self-identify. We encourage the utilization of the "Other" response option as a way to self-identify beyond the categories provided. Additionally, we have created a resource to explain the various category options further. We encourage everyone to educate themselves on the variety of ways individuals self-identify to promote learning and inclusive interactions. Learn more here: https://www.disabilitylead.org/resources/overview-of-disability-lead-demographic-options
Pronoun
She/her/hers
He/him/his
They/them/theirs
Ze/zir
Opt to not disclose
Other
Gender
Man
Woman
Transgender
Cisgender
Non-binary/gender non-conforming
Genderqueer
Two-spirit
Queer
Opt to not disclose
Other
Sexual Orientation
Asexual (aka "Ace")
Bisexual
Gay
Heterosexual
Lesbian
Queer
Pansexual
Opt to not disclose
Other
Race
African American or Black
American Indian
Arab American
Asian and Asian American
White
Hispanic or Latinx
Native American or Indigenous
Native Hawaiian and Pacific Islander
Two or more races
Opt to not disclose
Other
Do you identify as having a disability? If so, choose which you best identify as. If not, select I do not have a disability.
I do not have a disability
Autistic
Blind/low vision
Cerebral palsy
Chronic pain and/or chronic illness (including living with cancer, HIV/AIDS)
Deaf/hard of hearing
Intellecutal/developmental
Learning disability
Mental health
Physical
Opt to not disclose
Other
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Short answer questions
What would you like to learn or get out of being part of this community?
What strengths/skills/expertise/value can you contribute to the Collab?
Briefly describe what, if any, experience you have or work you have done in the area(s) of racial equity and/or disability justice? (NOTE: Previous experience is not required to join the community)
In the field below, indicate if you have any accommodation requests. Please be as specific and detailed as possible. Contact Risa Jaz Rifkind at rrifkind@disabilitylead.org or 312-994-4215 with any additional questions.
How did you find out about the Collab?
Email
Social media (Facebook, Twitter, LinkedIn, etc)
I'm a Disability Lead Member or Fellow
Word of mouth
Other
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Collab Community Agreements
The Collab will hold space consistently as a group to exchange ideas and support around shared values and goals for people in the Chicago region who are active or want to be active in disability rights and racial equity. To be part of this space, we ask that all members review and commit to upholding the goals and agreements linked below. You may want to download the document for optimal viewing. Please acknowledge that you have read and commit to these agreements by entering your name below.
Collab Guidelines and Agreements
Enter your name to indicate your acknowledgement and commitment to upholding the guidelines and agreements
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