Conversation 360°: DO NOT USE

The Conversation 360° is for individuals who are from a variety of backgrounds to come together in a well rounded discussion about issues in our community that impact the lives of children and adults living with a disability. To help us know who is in the room, please mark the indicator below to which you most closely identify.

We apologize for the inconvenience!

You've reached a form that is NO LONGER in use. Please visit us using the link below to register for the upcoming Conversation 360° sessions:

https://hipaa.jotform.com/disABILITYsa/conversation-360-rsvp

First Name Last Name

Area Code Phone Number

I agree to receive electronic information about disABILITYsa updates.

Hold shift key to select more than one discussion.

These next set of questions are optional and help us improve our outreach and funding efforts. Thank you for sharing with us.

There are six questions in this section.

Active Military/Spouse Military Veteran LGBTQ2+ I have autism I live with paralysis I have a disability

Under 18 18-24 25-34 35-44 45-54 55-64 65-74 75+ Prefer not to answer

Female Male Prefer to self-describe Prefer not to answer

American Indian or Alaska Native Asian or Asian American Black or African American Hispanic or Latinx White or Caucasian Prefer not to answer Native Hawaiian or other Pacific Islander Other

Not sure? Use this link to help you https://www.sanantonio.gov/Council.

Safety & Dating Romance Meeting Others Inclusion & Diversity Youth & Dating

12-17 years of age 18 years of age or older

The Dating & Disability discussion is restricted to 18 years of age or older. Since you are between the ages of 12-17 years of age, we will need your parent's permission for your participation. Please provide us with the name, phone, and email address of one of your parents/legal guardians.

First Name Last Name

Conversation 360° RSVP