2024 Disability Equality Training Facilitator Training  (DET FT): Application Form

Welcome to the application process for the Disability Equality Training Facilitator Training (DET FT). We are excited to have you consider participating in our training program and are here to assist you in any way possible. Our goal is to promote and support disability equity within organizations and society, and we believe that with your participation, we can make a positive impact in this area.

Please take the time to complete all items in the form provided below. If you have any questions or concerns about the form or its completion, please do not hesitate to reach out to the Secretariat for assistance.

  • Additionally, please note that there is an optional "Recommendation Form" available for submission if you have a recommendation by your organization via the following link:  https://forms.gle/rYJFxxVsqq6SMED76
  • In regards to this, organizations that plan to implement Disability Equity Training (DET) as an organizational activity will be given priority.

Please also note that the deadline for submission is 31 January 2024 at 24:00 hours.

For any further enquiries, please contact:
Ms. Supaanong Panyasirimongkol (NuNu),
Asia-Pacific Development Center on Disability (APCD)
E-mail: supaanong@apcdfoundation.org

We look forward to working with you and together, creating a more inclusive and equitable society.

Sign in to Google to save your progress. Learn more
Email *
1. Name *
2. Gender *
3. Year of Birth (Please enter only the year, without the date and month) *
4. Country *
5. Cell phone number (including your country code) *
6. Email address *
7. Have you previously participated in a Disability Equity Training program? *
8.  Reasonable Accommodations: We are committed to ensuring that all participants have equal access to the course. If you require any reasonable accommodations to fully participate, please specify them in the space provided. If none are needed, please indicate "none". Our team may reach out to you for additional information at a later date to ensure that your needs are met. We will make every effort to provide any necessary accommodations, however, please note that we cannot guarantee their provision. Thank you for bringing any necessary accommodations to our attention in advance. *
9. Type of impairment/disability (multiple selection possible) *
Required
10. Please provide a detailed description of your impairment. (For example: "I have a cervical spinal cord injury at the level of C7 as a result of a traffic accident that occurred when I was 25 years old. This results in complete paralysis of all four limbs and I rely on an electric wheelchair for mobility.")
11.  Lecturer Experience: If you have experience as a lecturer or facilitator, please provide as much detail as possible, with a focus on experience related to the field of disability. If you do not have any relevant experience, please indicate "none." (Example: "I have been a guest lecturer at a nursing school for the past 5 years, where I give a lecture on disability once a year. In 2019, I also presented a poster at the Society of Disability Studies on Community Based Rehabilitation.") *
12. Experience with Disability-Related Organizations: If you have experience working on disability issues, whether through membership in organizations or other means, please provide details. If not, please indicate "none." *
13. Please provide the reason for your application to participate in this Disability Equity Training Facilitator Training. *
14. Please indicate any previous experience you have using the following software, apps, and services that will be utilized in this course by checking the appropriate boxes. If you have no experience using any of them, please check "None of them". This training program requires proficiency in the use of Microsoft Office software, Zoom, and Google Space and Documents. Please note that there are numerous tutorials and usage guides available online for Zoom, so please review them in advance of the course. *
Required
15. Please describe your plans for implementing Disability Equity Training (DET) after completing this course. (Example: "Upon completion of the training, our organization plans to incorporate DET as a core program and conduct it on a monthly basis. As the organization will take on primary responsibility for implementing DET, we plan to prioritize these activities." Please also note that the example provided is just a format suggestion, but feel free to write however you like.) *
16. Does your organization have a plan to implement Disability Equity Training (DET) as a part of its program? If yes, please complete section 16 (1) to (5) with the relevant information.
 *
16 (1). Organization name
16 (2). Country
16 (3). Contact phone number (include country code)
16 (4). Name of person in charge
16 (5). Email address  of the person in charge of 16 (4). *
17. Lastly, are there any questions or other concerns that we can assist you with?
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of 特定非営利活動法人障害平等研修フォーラム. Report Abuse
Google Forms