Community Leaders' Disability Training Faciliator's Guides Archives - Page 2 of 2

1. Your name*

2. Your Organization*

3. Email*

4. In what organization, city, and country do you plan to use these materials?*

Street Address Address Line 2 City State / Province / Region Country

5. Please list other affiliate institutions or organizations

6. Which population/s do you anticipate will be using these materials in your setting?*

Select all that apply

Please specify:*

7. How would you describe yourself?*

Select all that apply

Please specify:*

8. All of our training materials are currently in English, what additional language translations would you find helpful?

9. I agree to complete a brief quarterly questionnaire asking for basic information about usage of the Kupenda resources*

This information will help Kupenda plan for expansion of this work.

Signature

validation_check*

Community Leaders' Disability Training Faciliator's Guides