Accessible Community Engagement Symposium
Wednesday, June 3 | 10:00-2:00 PM ET | YES Cinema and Kalsi Center, Columbus
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
County of Residence
Please Select
Adams
Allen
Bartholomew
Benton
Blackford
Boone
Brown
Carroll
Cass
Clark
Clay
Clinton
Crawford
Daviess
Dearborn
Decatur
DeKalb
Delaware
Dubois
Elkhart
Fayette
Floyd
Fountain
Franklin
Fulton
Gibson
Grant
Greene
Hamilton
Hancock
Harrison
Hendricks
Henry
Howard
Huntington
Jackson
Jasper
Jay
Jefferson
Jennings
Johnson
Knox
Kosciusko
LaGrange
Lake
LaPorte
Lawrence
Madison
Marion
Marshall
Martin
Miami
Monroe
Montgomery
Morgan
Newton
Noble
Ohio
Orange
Owen
Parke
Perry
Pike
Porter
Posey
Pulaski
Putnam
Randolph
Ripley
Rush
Scott
Shelby
Spencer
St. Joseph
Starke
Steuben
Sullivan
Switzerland
Tippecanoe
Tipton
Union
Vanderburgh
Vermillion
Vigo
Wabash
Warren
Warrick
Washington
Wayne
Wells
White
Whitley
Affiliation
Please select all the categories that describe you:
*
Person with Lived Experience - Individuals with disabilities who are directly affected by policies related to community engagement and can offer insights into the day-to-day challenges they face.
Advocate (Paid or Volunteer) - Individuals who are actively engaged in advocacy work, either as a paid professional advocate, a volunteer advocate spending a substantial amount of time in policy-related activities, or those whose employment includes advocacy work.
Policy Maker (Elected or Appointed) - Individuals in elected or appointed positions responsible for making or changing policies. This includes officials who have the authority to influence policies at various levels of government.
Please order these breakout rooms based on your interest, passion, and/or work:
Please share any accommodation needs:
Please share any dietary restrictions:
Submit
Should be Empty: