BOARD MEETING REMOTE REQUEST

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Act 393 of the 2023 Regular Session of the Louisiana Legislature amended Louisiana law [La.R.S. 42:14(E)] to allow any member of the public with a disability recognized by the Americans with Disabilities Act (ADA), or a designated caregiver of such a person, to participate in the meetings of public bodies.

Please complete and submit this form if you are a person with a disability recognized by the ADA, or you are a caregiver of a person with a disability recognized by the ADA, and you wish to participate remotely in the public portion of a Board Meeting

Email *

Full Name of Participant

Street Address *

City *

State *

Zip Code *

Email address *

Phone Number *

I (or the person for whom I serve as caregiver) request the opportunity to comment at the following meeting:
*

YYYY

Certifications & Acknowledgements: *

I understand that an individual with a disability is defined by the ADA as a person who has a physical or mental impairment that substantially limits one or more major life activities or a person who has a history or record of such an impairment. Act 393 of 2023 only authorizes electronic participation in Board Meetings by "any member of the public with a disability recognized by the Americans with Disabilities Act or a designated caregiver of such a person." By checking this box, I certify that I am a person with a disability recognized by the ADA or a designated caregiver for a person with a disability recognized by the ADA.

I understand that any member of the public who is permitted to speak in a Board Meeting must refrain from using profanity or inappropriate sounds/language. Failure to comply will result in removal from the meeting electronically or otherwise.

I understand that I will be emailed the contact information for the upcoming teleconference into the Board Meeting, and that I must call into the meeting at least 10 minutes before the meeting begins, from the phone number I have listed above.. Further instructions will be in the email.

Required

By typing my name I am signing this form. *

Date Request was Made and Submitted:

YYYY

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