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Guide to Planning Inclusive Meetings

Appendix B

Sample Event Registration Form/Application for Accessibility Requirements

You can use the sample registration form on the next page to request accommodation information from the participants.

As an alternative to the form, event planners could ask participants for accommodation information by sending them an invitation that includes the following text:

Appendix B.1
Sample Event Registration Form

“If you require documents in formats other than conventional print, or if you have specific accommodation or dietary needs, please let us know so we can make arrangements in advance. Please also identify any assistance you may require in the event of an emergency evacuation. For more detailed information, call ___________________________ at _________________________.”

“Please indicate your requirements to help us plan an event that meets your accommodation and inclusion needs. If you have any questions or concerns, please contact ___________________________ at _________________________.”

Appendix B.2
Application for Accessibility Requirements

A    Mobility requirements
  • Ο  Physical accessibility (specify) ___________________________________

B    Language requirements
  • Ο  Simultaneous interpretation

  • Ο  American Sign Language (ASL)

  • Ο  Langue des signes du Québec (LSQ)  

C    Service requirements
  • Ο  Oral interpreter

  • Ο  Assistive listening system

  • Ο  Intervenor

  • Ο  Advisor

  • Ο  Real-time captioning

D    Alternative media requirements
  • Ο  Large print

  • Ο  Audiocassette

  • Ο  Braille

  • Ο  Diskette/CD/flash drive (please specify) ___________________________

  • Ο  DAISY

  • Ο  Descriptive video

  • Ο  Captioned video

E    Other requirements – Please specify
  • Ο  Dietary ______________________________________________________

  • Ο  Evacuation needs _____________________________________________

  • Ο  Overnight accommodations _____________________________________

  • Ο  Name of attendant/coach accompanying me to event

    (first name, last name)  ________________________________________

  • Ο  Other:

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Date Modified:
2011-07-27