Candidate Name:

Contact Person:

If there is a Campaign office, is it wheelchair accessible?

Campaign Address:
Phone:
Fax:
Address:
Email:
Website:

Endorsements: (Political, Community & Labor)

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

    

    

2. How will you incorporate people with disabilities into your campaign?

    

    

3. If you are in private practice, is your office accessible to people with disabilities? If not, what have you done to ensure access?

    

    

4. Is the courthouse in which you work accessible to people with all kinds of disabilities? If not, what have you done to ensure access?

    

    

5. Has a person with a disability appeared before your court as a juror or litigant? If so, please indicate what, if any, challenges arose? And how were they handled?

    

    

6. Do you believe that a person who is deaf / hard of hearing or one who is blind/or has low vision can serve as a juror? Why or why not?

    

    

7. Are you willing to hire either on a job share or full time basis, a qualified law clerk/secretary with a disability?

    

    

8. How will you work within the court structure to assure the accessibility of all facilities of the courts? For example, will you participate in the Committee for People with Disabilities, relevant training opportunities?

    

    

9. How would you act when the family of a person with physical or cognitive disabilities attempts to control their assets?

    

    

Date: ______________________