Speak Up Stand Up Summit Registration

Summit Registration

For the Speak Up Stand Up Summit
Join us for this virtual 3-day summit to connect, advocate, and take action together as a community!

Day #1 Friday, January 9 | 10:00 am - 12:30 pm
Day #2 Friday, January 16 | 10:00 am - 12:30 pm
Day #3 Thursday, January 22 | 10:00 am - 12:30 pm

The Speak Up Stand Up Summit is a series led by people with disabilities, for people with disabilities.

Learn more: https://lsuh.sc/ahspeakupstandup
Your Name*

First NameLast Name
Your Email*
example@example.com
This is a virtual 3-Day Summit. Please select the days that you plan to attend.*

Friday, January 9th from 10:00 am-12:30 pmFriday, January 16th from 10:00 am-12:30 pmThursday, January 22nd from 10:00 am-12:30 pm
How do you identify?*

I am a person with a disabilityI am a family member to someone with a disabilityI do not have a disabilityI am someone who works with people with disabilitiesOther
Which Parish do you live in?*
Becuse you live in {whichParish}, you are located in Louisiana's Region 1.
Becuse you live in {whichParish}, you are located in Louisiana's Region 2.
Becuse you live in {whichParish}, you are located in Louisiana's Region 3.
Becuse you live in {whichParish}, you are located in Louisiana's Region 4.
Becuse you live in {whichParish}, you are located in Louisiana's Region 5.
Becuse you live in {whichParish}, you are located in Louisiana's Region 6.
Becuse you live in {whichParish}, you are located in Louisiana's Region 7.
Becuse you live in {whichParish}, you are located in Louisiana's Region 8.
Becuse you live in {whichParish}, you are located in Louisiana's Region 9.
Becuse you live in {whichParish}, you are located in Louisiana's Region 10.
This next question is about Advocacy.

Advocacy is when you share your ideas or experiences to help change rules, policies, or attitudes.
How experienced are you with advocacy?*

Advocacy is new to me.I understand what advocacy is.I have participated in an advocacy program.I am involved with my LaCAN group.
Do you need accommodations to fully participate in the summit?

Live CaptioningSign Language InterpreterPresentation materials before the eventTranscripts and Recordings after the eventI do not need accommodationsOther
How did you hear about this event?*

FacebookInstagramFamily or friendEmail newsletterAn organization shared it with meOther
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