Maker Space Accessibility Request

Maker Space Accessibility Request Form

Public ASL Interpreter/other accessibility needs request form for a Maker Space visit.

"*" indicates required fields

First Name*

Last Name*

Email Address*

Phone Number

Purpose of Visit*

Describe which piece of Maker Space equipment you would like to use and what you would like to make with it

Preferred Dates

Pick 3 dates and based on staff availability we will choose one of the dates for the appointment. In the rare circumstances staff aren't available on any of the dates you will be contacted to choose another potential date.

Preferred Date 1*

MM slash DD slash YYYY

Preferred Date 2*

MM slash DD slash YYYY

Preferred Date 3*

MM slash DD slash YYYY

What time of day would you prefer to come in?*

Morning

Evening

If you require assistive services, which would you require?

ASL Inteprpreter

Language Line

Speech Tablet

Will a hearing participant visit with you?*

Yes

No

If YES, hearing participant's first and last name

CAPTCHA

Phone

This field is for validation purposes and should be left unchanged.

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One the Esplanade
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Pickering, Ontario
L1V 2R6

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