ADA Information - DBTAC Rocky Mountain ADA Center

Outreach Request

Outreach Request Form

3630 Sinton Road, Suite 103

Colorado Springs, CO 80907-5072

800-949-4232 (V/TTY) 719-444-0269 (FAX)

Name: *

Organization: *

Address: *

City: *

Phone: *

Fax: *

E-mail: *

Requested Date: *

Start Time for Event: *

Length of Event: (Hrs) *

Event Name: *

Event Location: *

Is the event location accessible to individuals with disabilities? *

Yes

How many attendees are expected? *

What is the general makeup of the attendees? (e.g. background, interest, knowledge of the ADA, etc.): *

What kind of materials would you like us to bring to the event? (e.g. general ADA, employment, public entities, private entities, architectural access, etc.): *

Would you like us to provide a door prize? *

Yes

Is there a participation fee for the event? *

Yes

If yes, what is the cost?

The Rocky Mountain DBTAC is authorized by the National Institute on Disability and Rehabilitation Research (NIDRR) to provide information, materials, technical assistance, and training to entities who are interested in the Americans with Disabilities Act (ADA). However, neither NIDRR nor the DBTAC is responsible for the enforcement of the ADA. The information, materials, technical assistance, and training provided are intended solely as informal guidance, and are neither a determination of your legal rights or responsibilities under the Act, nor binding on any agency with enforcement responsibility under the ADA.

* Denotes a required field.