Community Engagement Event Request | Access Ability Wisconsin, Inc.

Please complete this form to the begin your request for AAW adaptive equipment at your organization's Community Engagement Event.

Short Description of Event (1-2 Paragraphs)

Will you need a link to sign up volunteers for the event?

Yes

Event Primary Contact: Please enter contact information for the primary contact individual for the event/location.

Primary Contact First Name

Primary Contact Last Name

Primary Contact Email

Primary Contact Phone

AAW Primary Contact: In most cases, this is contact information for the person filling out this form.

AAW Contact First Name

AAW Contact Last Name

AAW Contact Email

AAW Contact Phone

AAW ID# (Organization)

Community Engagement Event Title

Physical Address of Community Engagement Event

Community Engagement Event Date(s)

Start Time

End Time

Number of OWCs Potentially Needed

Upload Event Flyer (or Pictures from Previous Event)

Select File