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Saratoga Federated Student Inclusion Form
Thank you for your interest in participating with Saratoga Federated Church.  We strive to be inclusive of all abilities and welcome you. These questions are asked for yours, or your family members, benefit so we can provide the best experience and safest environment for everyone. Our ministry leaders and volunteers take very seriously your right to privacy. Any information shared from this form is communicated directly with those caring for or serving you directly and only on a "need to know" basis. After submitting the survey, the Inclusion coordinator will set up a time with you or your representative to review the form together to make sure everyone is on the same page. If certain questions do not apply, please feel free to put "N/A" in that field. Thank you for the privilege of getting to know you
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Name of person desiring supports:
Best email for communication: *
Who is filling out this form? *
Date of Birth for person desiring supports? *
MM
/
DD
/
YYYY
I have the following disability(s): *
Main form of expressive communication? *
Main Form of receptive communication? *
My areas of interest include *
Barriers to my engagement with others include? *
My triggers are.. *
The things that most help me manage my triggers are? *
Medical Issues we should be aware of (fainting, seizures, etc) *
Things that will help me more easily engage with other people (quiet area, interpretation, designated seating….)
 *
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