Accessibility and Inclusion - Request for Services Form

If you have any special needs that we can reasonably accommodate, please indicate them below by completing the survey. Thank you, and AAAS must have requests by January 24, 2018. If there are any issues with your requests, we will reach out and discuss them with you.

Please provide us your contact information.

*This question is required.

First Name

Last Name

Email Address

Phone Number

Mobile Phone

2. Please let us know what assistance you will need

Visual
Audio
Mobility
Other Please enter an 'other' value for this selection. * This question is required.

3. Will you need any of these services?

A scooter?
ASL interpreters?
Other? Please enter an 'other' value for this selection. * This question is required.

4. Scooters will be available at Annual Meeting registration area.

Please bring a photo ID to when checking out the scooters. Equipment is ordered based on requests made before the Annual Meeting. AAAS will attempt to accommodate requests made after January 24, 2018, but cannot guarantee those.

What date will you need the scooter?
This question requires a valid date format of MM/DD/YYYY.

calendar

When will you need an ASL interpreter?

Please list the titles of the individual sessions from our on-line program (available in October 2017). AAAS will attempt to accommodate requests made after January 24, 2018, but cannot guarantee those.

Please note: Attendees can request sign language interpreters for the Annual Meeting. Interpreters are available for symposia, seminars, topical lectures, business meetings, clinics, and workshops. For all other events, please make arrangements with the interpreter separately at the individual's cost.

Space Cell	Date	Start Time	Title
Session	Session: Date	Session: Start Time	Session: Title
Session	Session: Date	Session: Start Time	Session: Title
Session	Session: Date	Session: Start Time	Session: Title
Session	Session: Date	Session: Start Time	Session: Title
Session	Session: Date	Session: Start Time	Session: Title