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LWYL Community Workshop Request Form

Home > LWYL Community Workshop Request Form

Request for aids or services

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Request form for special aids or services

Only complete this form if you require a special accommodation to attend a meeting.

Name *

First

Last

Email *

Phone *

Which workshop do you plan to attend? *

Buhler, 6 to 7:30 p.m. Oct. 28
Fairfield Area, 6 to 7:30 p.m. Nov. 13
Nickerson, 6:30 to 8 p.m. Nov. 18
Haven/Yoder, 6 to 7:30 p.m. Oct. 16
Hutchinson, 8:30 to 10 a.m. Oct. 29
Hutchinson, 4 to 5:30 p.m. Oct. 29
Hutchinson, 6 to 7:30 p.m. Oct. 30
Hutchinson, 1 to 2:30 p.m. Nov. 2
Pretty Prairie, 7 to 8:30 p.m. Nov. 20
South Hutchinson, 6 to 7:30 p.m. Oct. 15

Aids or services

Pursuant to the Americans with Disabilities Act, do you require aids or services? *

American Sign Language (ASL) Interpreter
Assistive Listening Device
Captioning
Large Print
Braille
Reserved Seating
None
Other:

Other aid or service not listed above.

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Hutchinson Community Foundation
1 N. Main, Ste. 501 | P.O. Box 298
Hutchinson, KS 67504-0298
Phone: 620-663-5293

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