"A Seat at the Table..." Table Leader Screening Form

In February 2024, the Georgia Council on Developmental Disabilities Storytelling Project is proud to partner with Equitable Dinners to offer two innovative, unique evenings.

PLEASE NOTE: We are seeking table leads (people with I/DD) for two distinct but related events. These events are both intentionally placed the night before GCDD Advocacy Days with the explicit hope that they will segue into the next day's opportunity for advocacy and legislative activities.

Tuesday, February 6, 6:00-8:00p--PLEASE NOTE: THIS EVENT AND ITS TABLE LEAD APPLICATIONS ARE NOW FULL! PLEASE TURN YOUR ATTENTION TO OUR TABLE LEAD APPLICATIONS FOR THE VIRTUAL STATEWIDE EVENT BELOW!

An in-person gathering in Atlanta at Georgia Public Broadcasting, 260 14th St NW, Atlanta, GA 30318.
This is a live, in-person event that features a catered meal for up to 120 people.
We are seeking 10 table leaders (people with I/DD), along with their 10 DSPs / caregivers / family member.
Table leaders and their DSPs will each be paid $120 for their training and participation.

Tuesday, February 27, 6:00-8:00p

A virtual, statewide gathering.
This is a live virtual event held on Zoom.
We are seeking 10 breakout room leaders with their 10 DSPs / caregivers / family members.
Leaders and their DSPs will each be paid $120 for their training and participation.

Training
All trainings will take place via Zoom and will include CART/ASL.
Each event will include a time for Q&A re: logistics for the upcoming Equitable Dinner, as well as a training on how to hold space and be a table or breakout session leader (depending on if you are leading at in-person or virtual event).

Training Opportunites In Preparation for the February 6 In-Person Event

Tuesday, January 30 at 12p
Thursday, February 1 at 6p

Training Opportunites In Preparation for the February 27 Virtual Event

Tuesday, February 20 at 6p
Thursday, February 20 at 12p

Compensation

If you are selected as a table/breakout leader, you and your DSP will be compensated in the amount of a one-time payment of $120 for your training and participation in the event. In order to maximize participation and leadership of as many people with disabilities across the state, ideally, we would not have a crossover of leaders at both the in-person and virtual event.

In other words, please make a choice between which event you'd most prefer to serve in leadership.

Name*

First NameLast Name

Email*

example@example.com

Phone Number*

Please enter a valid phone number.

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

I and my DSP are interested and available for:*

The virtual, stateside event on Tuesday, February 27

I understand that I would need to be available to participate in training in order to do one of these events above. As such, I can currently commit to training on:*

Tuesday, February 20 at 6p (In Preparation for the February 27 Virtual Event)Thursday, February 20 at 12p (In Preparation for the February 27 Virtual Event)

Do you have a disability?*

YesNo

What is your disability / disabilities?

Please check as applicable

I have an Independent Care WaiverI am on the waitlist for the Independent Care Waiver Program (ICWP)I have a New Options Waiver (NOW)I am on the waitlist for the New Options Waiver (NOW)I have a Comprehensive Supports Waiver (COMP)I am on the waitlist for the Comprehensive Supports Waiver Program (COMP)None of the aboveOther

Age*

Race*

Ethnicity

Language Spoken

How do you prefer to communicate? (Ex. Do you use an adaptive or assistive device?) Any other accommodations you would need to participate successfully?

I understand that the table leader will receive a one-time payment of $120 for training and participation in the Equitable Dinners event.*

Yes

If you have a photo of yourself, especially one of together with your DSP, we'd love to see it. If adding that here is hard, please feel free to email it separately to storytelling@larcheatlanta.org.