LAPTIC Stakeholder Group Registration

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Thank you for your interest in joining our Stakeholder Advisory Group! We are excited you're here. By completing the following registration, you are agreeing:

to participate in periodic reviews of FHF of GNO materials, trainings, and online resources by giving your feedback on how they could be improved;
to attend monthly or bimonthly virtual or teleconference meetings with group members;
to complete online surveys sent to you by our Group Facilitator as needed;
to receive emails and information in the mail from the Group Facilitator periodically, with group information and instructions on product reviews.

Below are some questions about you and/or your child who has an exceptionality. Some of the questions may seem irrelevant, but we need the information to be sure we assign as diverse a group as possible to each product review. Your information is private and confidential and will be treated as such.

* Your first and last name

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* Your street address, including city, zip code and apartment number, if applicable

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* Your parish

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* Email address that you check regularly

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* Telephone number(s) with area code

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* In what type of area do you live?

Rural/Country

Suburban/Smaller city or town

Urban/Big city

* What is your race?

African-American

Asian

Caucasian

Hispanic/Latino

Native American

Pacific Islander

Two or more races

Other

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* What is the primary language spoken in your home?

English

French

Spanish

Vietnamese

ASL

Other

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* What is the name of your child (or children) who has a exceptionality?

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* What is the birthdate of your child (or children) who has a exceptionality?

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* What is the primary exceptionality your child (or children)?

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* Do you identify as a person with a disability?

Yes

* Do you consider yourself low income?

Yes

* Do you now or have you ever had a child 18 or younger in a juvenile detention center?

Yes

* Are you a foster parent of a child with a learning difference, exceptionality or special healthcare need?

Yes

* Do you have access to a laptop, desktop or tablet computer with which to review products?

Yes

* Do you have reliable internet service?

Yes

* Are you able to participate in Zoom (virtual video) meetings to provide input about the products reviewed?

Yes

* Will you need products submitted to you in a different format, such as print media sent through the mail?

Yes

* Do you understand that LAPTIC Stakeholder Advisory Group members are volunteers and not paid for their participation?

Yes

If you have any questions, comments or concerns about the LAPTIC Stakeholder Group please list them here.

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Thank you so much for your interest in Families Helping Families of Greater New Orleans and the LAPTIC Stakeholder Group. Our LAPTIC Group Facilitator will be contacting you shortly with information on upcoming meetings and assignments. We appreciate your time and look forward to getting to know you!

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