Candidate Name: _________________________________________

Campaign Manager: ______________________________________

Phone: __________________ Fax: _________________________

Campaign Name: _________________________________________

Campaign Address: ________________________________________

Contact Person: _________________________________________

Phone: __________________ Fax: _________________________

Email: ___________________ Website: _____________________

1. Please describe any experience with disability you have had in your life or career.

    

    

2. Is your campaign headquarters accessible to persons with disabilities? If you are an incumbent, is your district office accessible to persons with disabilities?

    

    

3. How will you incorporate people with disabilities into your campaign? Are you willing to hire and use flex-time and job-sharing if necessary?

    

    

4. While in public office/prior to this campaign, what have you accomplished in regard to advancing disability rights? This can include work towards accessible housing, transportation, employment, health care, education, and including people with disabilities in the political process?

    

    

5. What oversight have you performed regarding implementation of programs/legislation you have passed (in previous offices)?

    

    

6. What implementation strategy do you have for your future programs and legislation to help constituents with disabilities?

    

    

7. Will you commit to only attend or sponsor events that are accessible to people with disabilities? This includes providing written materials in alternate formats for people with low vision, providing assistive listening systems for people who are hard-of-hearing, and sign language interpreters for people who are deaf, as well as ensuring that locations are accessible to people who use mobility aids, like wheelchairs and walkers?

    

    

8. What personal and professional experience have you had with people with disabilities?

    

    

9. How do you propose your active involvement/availability to the disability community? Will there be a specific person in your office responsible to this community? Will have regular office agenda meetings on these issues? What would you do to have direct contact with our community?

    

    

10. Do you favor the incorporation of the housing provisions of Titles II and III of the Americans with Disabilities Act into NYS Human Rights Law (A.7294/S5074, A. 6328/S.3921)

     

     

11. Do you support a ban of the use of solitary confinement in Special Housing Units of people with psychiatric disabilities in state correctional facilities (A.3926/S.2207)?

     

     

12. Federal courts often rule on challenges to the ADA in a manner never intended by its authors. Do you pledge to use your office to affirm or strengthen, rather than weaken, civil rights protections to persons with disabilities? Do you support a waiver of the state's sovereign immunity claims under the ADA and Section 504 of the Rehabilitation Act of 1973 (A.2159)?

     

     

13. Persons with disabilities have historically been under-represented within the Democratic Party leadership. According to the 2000 census, persons with disabilities comprised 20.6% of all residents in New York State and 23.1% of population 18 years and older. Previously, we were told that only those groups included in the Voting Rights Act were included in the goals and timetables for delegate selection. Yet the lesbian and gay communities were included for the first time at the 2000 convention and again at the 2004 convention. Would you support a campaign to set a goal that 10% of the total New York State Delegation to the 2008 Democratic National Convention be comprised of persons with disabilities?

     

     

Candidate Signature: ___________________________________

Date: ______________________