PIERCE COUNTY IDD LEGISLATIVE FORUM
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Legislative Forum Speaker Form
Legislative Forum Speaker Form
Date: November 19, 2024
Time: 6:30 - 8:30pm
Location: Tacoma Community College Campus, Building 11
Why does this event take place?
Over 25 years ago Pierce County began hosting the Legislative Forum to educate, inform, collaborate, and create change. For too long individuals who experience intellectual and developmental disabilities (I/DD), their families, friends, and allies have not been heard. The point of the forum is to convene into action “nothing about us without us.” A slogan that indicates the active involvement of persons with I/DD in the planning of strategies and policies that affect their lives. We need legislators to “Keep the Promise.” .
What is a speaker?
Please be advised that speakers for the Pierce County DD Legislative Forum will be individuals with lived experience – a person with IDD, their family, allies, and/or friends who can share their story with one or more of the priorities identified by Pierce County DD Advisory Board, how it impacts their life, what they need, etc. with legislators for the change they need. Speakers are not to share or promote any business, networking, marketing, and/or anything related to their profession. It is strictly first-person stories as it relates to change the legislators can pursue.
If this applies to you and/or those you know, we welcome your submission.
Who is the audience?
Individuals who experience an intellectual and developmental disability (I/DD)
Families, friends, and community allies of someone who experiences an intellectual and developmental disability (I/DD)
Pierce County legislators and their staff
Community members who want to listen, learn, and join us in supporting the legislative priorities in Pierce County
About the Process:
All speakers will be recorded for the Legislative Forum prior to the event. A signed and submitted media release (found at the bottom of this webpage) is required to be a speaker for this event. If you have your story recorded at this time, you will be able to uploaded it below or it can be
emailed to PAVE
by November 8, 2024.
PAVE reserves the right to edit the recording as needed for clarity and time restraints.
Your Contact Information
First Name
Last Name
Email
Mobile Phone
County
Please select...
Adams
Asotin
Benton
Chelan
Clallam
Clark
Columbia
Cowlitz
Douglas
Ferry
Franklin
Garfield
Grant
Grays Harbor
Island
Jefferson
King
Kitsap
Kittitas
Klickitat
Lewis
Lincoln
Mason
Okanogan
Pacific
Pend Oreille
Pierce
San Juan
Skagit
Skamania
Snohomish
Spokane
Stevens
Thurston
Wahkiakum
Walla Walla
Whatcom
Whitman
Yakima
Out of State
Optional Demographic Information:
My Gender Identity
Please select...
Female
Male
Trans Woman
Trans Man
Non-Binary or Genderqueer
Agender
Other
Prefer Not to Answer
My Pronouns
Please select...
She/Her
He/Him
They/Them
Other
My Sexual Orientation
Please select...
Heterosexual or Straight
Gay
Lesbian
Bisexual or Pansexual
Other
Prefer Not to Answer
My primary language is
Please select...
English
Spanish
Russian
Vietnamese
Somali
Ukranian
Chinese
Chinese-Cantonese
Chinese-Mandarin
Chinese-Unspecified
Korean
Tagalong
Arabic
Punjabi
Cambodian
Marshallese
Samoan
Amharic
Japanese
Rumanian
French
Nepali
Mixteco
Lao
Hindi
Sign Language
Other
We ask this to better serve you in your preferred language, as possible.
x
Other primary language
My ethnicity
Please select...
Hispanic or Latino
Non-Hispanic or Non-Latino
Unknown
My race is (Check all that apply)
Caucasian/White
Black or African American
American Indian/Native American/Alaska Native
Asian
Pacific Islander/Native Hawaiian
Two or more races
Unknown
About Yourself & Your Story
What DDA priorities does your story discuss
Please select...
Choice A
Choice B
Please tell us about yourself! Let us know who are you, why are you speaking on this topic, and what do you want legislators to do for you.
PAVE will be crafting your biography based on what you provide below.
PAVE reserves the right to edit your information for space and clarity.
Brief Biography
Media Release:
It is the policy of PAVE to require all speakers/presenters to sign and return a Media Release to participate. The form can be found at the bottom of this webpage. The media release can be uploaded to this form or
emailed to PAVE
by November 8, 2024.
Speakers/Presenter under the age of 18 years will need a guardian to sign the release in addition to the speaker.
I will be submitting my signed Media Release via
Uploading to this form
Emailing to PAVE at
[email protected]
Signed Media Release
Recorded Story:
If you have your story recorded at this time, you will be able to uploaded it below. Or it can be
emailed to PAVE
by November 8, 2024.
PAVE reserves the right to edit the recording as needed for clarity and time restraints.
I will be submitting my recorded story via
Uploading to this form
Emailing to PAVE at
[email protected]
Recorded Story
Thanks! At the bottom of this page is the Media Release form. Please fill that out and upload in the form above or email to
[email protected]
.
Please only click submit once, the form takes a minute to process. Thank you!
Contact Information
Please fill out this
Media Release
and send it to
[email protected]
Thank you!
Home
About
Priorities
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Past Recipients
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