Anonymous Access Needs form: CAN Lotterywest Story Street Attendees

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This is a short form so we can be notified about any access needs that you may have as a person with disability, and ways that we can provide you with assistance and access to Lotterywest Story Street events. We would like for our events to be accessible, comfortable and safe for you to attend, so please let us know how we can best cater for your needs.

You may also inform us of your access needs by contacting us directly, whether in person, over the phone, or via email. Lotterywest Story Street Project Coordinator: Emele (emele@canwa.com.au).

Community Arts Network Toll Free phone line: 1800 681 021

Or you can contact us through the National Relay Service:
TTY users phone 133 677
Speak and Listen users phone 1300 555 727
Or via internet-relay.nrscall.gov.au

Which Lotterywest Story Street event/s will you be attending?

Please include the event title and date.

What would help make the venue/s location safe and accessible to you?

What would help make the event/s safe and accessible to you?

Would you like a partitioned quiet space at the event/s to relax while the event is on?

Yes

Other:

Clear selection

Do you have any dietary requirements or require specific catering?

Do you need to be assisted with or provided the following...

Eating

Plating your food

Food being cut up into small pieces

Plastic straws

Sunglasses for bright rooms

Ear plugs

Headphones

Other:

Would you like an AUSLAN interpreter at the event/s?

Yes

Other:

Clear selection

Do you require any interpretation services at the event/s? If so, which languages?

Would you like to say anything else about your access needs?

Submit

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