Do you currently receive services from Disability Network of Wayne County Detroit *
What is today's date? *
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What is your First and Last Name? *
Please enter your name information:
Your answer
What is your current telephone number? *
Your answer
What is your mailing address? *
Your answer
What is your email? If you don't have one, please leave blank.
Your answer
Do you currently (today) have access to a laptop, tablet, or computer to participate in an online program? *
Do you currently (today) have high speed internet access to participate in an online program? *
Are you interested in participating online at least 3 times a week, if provided the resources (internet service, tablet, and programming)? *
The programming will continue to be healthy and informative. Are you willing to you communicate and share your feelings and info whether weeks of healthy and sociable programming have improved your life during this pandemic? *
Please review the list of suggested classes to provide within this program.
Are there any other issues you may have that online or in-person classes may not address? (after reviewing the class list)
Your answer
Are you willing to answer some questions regarding your experience, quarterly, while you are participating online, and after you stop participating? *
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