Wisconsin Assistive Technology Advisory Council Application, F-02574 (12/2019)

Introduction/Contact Information

Thank you for your interest in joining the Wisconsin Assistive Technology Advisory Council.

Submission of this application of interest does not guarantee you will be appointed to the Council. Appointments are made based on vacancies and specific representation needs. Applications expire one year from date of submission.

Council members consist of the following representatives:

Individuals with disabilities who use assistive technology (AT)
Family members or guardians representing a person with a disability who uses who uses AT

AT Council members provide guidance and direction related to AT products and services throughout Wisconsin. Participation in four quarterly meetings per year, along with any committee meetings is required. Meetings are typically conducted through video conferencing. Any meeting held in person will allow for reimbursement for travel expenses (mileage, meals, and lodging).

If you have any questions or need assistance completing this application, contact Laura Plummer at 608-514-2513 or laura.plummer1@dhs.wisconsin.gov.

Contact Information *This question is required.

First Name *This question is required.

Last Name *This question is required.

Street Address *This question is required.

City *This question is required.

State *This question is required.

Zip Code *This question is required.

County *This question is required.

Daytime Phone Number *This question is required.

Email Address *This question is required.