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Peer Facilitator Intake
My first name is
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My last name is
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My email address is
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What interests you in collaborating with AKALAKA and/or being a part of this program?
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Please describe any background (personal or professional) that you have related to intellectual and developmental disabilities (IDD) and/or caregiving.
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Below is a (non-exhaustive) list of different areas of inclusion we are committed to. For each topic, please select the option(s) that best describe your familiarity with the topic.
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I have lived with this experience and/or identify as part of this group
I feel very comfortable/knowledgeable on this topic
I am committed to being inclusive in this area but do not have extensive knowledge
I am uncertain or have some reservations about this topic
Inclusion for people with under-represented racial and ethnic identities
Inclusion of girls and women
Inclusion of disabled and/or neurodivergent individuals
Inclusion of people in the LGBTQ+ community
Inclusion of people who are poor and/or working class
Inclusion of people living with caregiving responsibilities
Please provide any additional information you'd like to share about your responses above
What languages would you be comfortable facilitating a cohort in?
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Is there any way that AKALAKA can make participation in this more comfortable and/or accessible for you?
Is there any other information you would like to share?
Submit