Accessibility Advisory Committee Extended Halifax Public Libraries: Accessibility Advisory Committee Application For more information about the Accessibility Advisory Committee, please click here. * indicates a required field Step 1 of 4 25% Contact Information1) Name * Required First Last 2) Preferred Name3) Personal PronounSheHeThey4) Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code 5) Phone6) Email * Required 7) How would you like us to contact you if you are selected for an interview? * RequiredEmailPhoneVoice/TTY8) How did you hear about the Accessibility Advisory Committee?FriendOrganizationSocial mediaLibrary websiteAdvertisement Next Save and Continue Later Interest9) Why are you interested in participating in this committee?10) What do you hope you can put in motion as a member of this committee? Previous Next Save and Continue Later Experience11) My experience is best described as: * RequiredLived experienceExperience as an advocate for a friend or loved oneWork experience with an accessibility-related group or organization12) Are you a person who lives with a disability or impairment? * RequiredYesNo12b) Under which category does your disability fit? * RequiredPlease select all that apply. Mobility and Physical Intellectual or Learning Psychiatric Visual Hearing Neurological 13) Are you a member or employee of an organization representing people with disabilities? * RequiredYesNo13b) Which organization? * Required14) Do you have experience working with people of varying abilities?YesNo14b) Will you please share one example of where you worked or volunteered and briefly outline your role and responsibilities?15) Do you have experience serving on a board or advisory committee?YesNo15b) Please Describe your experience serving on a board or advisory committee.16) Please indicate which of the following areas you have knowledge and understanding of, as they relate to accessibility and accessible practices: * RequiredPlease select all that apply. Built environment Education Employment Goods and services Information and communications Transportation Previous Next Save and Continue Later AvailabilityThe Library will work with successful applicants to determine the most suitable times and locations for Accessibility Advisory Committee meetings. Members of this committee must be able to commit to approximately 3 hours of volunteer time per meeting, 4-5 times per year.17) Are you able to commit to attending 4-5 meetings per year? * RequiredYesNoApplication DeadlineJanuary 24, 2021 at 11:59PMPhoneThis field is for validation purposes and should be left unchanged. Previous Close Can you tell me more about this webform submission? The contents of this webform are sent to library staff via email. We recommend that you do not submit confidential information (like your library card number, passwords or credit card information). If you need to share confidential information with library staff, we suggest that you use other channels of communication, such as the telephone.Visit our Privacy Statement, opens in a new window, opens a new window to learn more about how your personal information is handled and protected. This information will be submitted via email. Learn More about sending data over email. Save and Continue Later This iframe contains the logic required to handle Ajax powered Gravity Forms.