Spokane County Parent Coalition Form

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SPOKANE COUNTY PARENT COALITION

Become involved in advocacy through The Arc with the Spokane County Parent Coalition.

The Parent Coalition is a group of parents, caregivers, and guardians in Spokane County with loved ones with intellectual and developmental disabilities (IDD). We serve as advocates and thought leaders for guiding the county’s work on behalf of all people with IDD to promote an inclusive community that celebrates diversity as opposed to just accommodating it.

First Name*

Last Name*

Email Address*

Cell Phone

Address, line 1*

Address, line 2

City*

State*

Zip Code*

What is your legislative voting district?

Not sure of your district? Find my district here.

Are you a parent/guardian/family member of children with IDD?

Please indicate whether you are interested in the following IDD-related issues:

Are you interested in Social Security issues?

Are you interested in guardianship-related issues?

Are you interested in employment issues?

Are you interested in DDA issues?

Are you interested in transition services issues?

Are you interested in community-based living services issues?

Are you interested in Medical/Medicaid/health insurance issues?

Are you interested in de-institutionalization issues?

Are you interested in housing-related issues?

What is your primary spoken language?

Do you need technical assistance?

Do you need an interpreter?

Yes No

Do you have a disability?

Yes No

What is your gender?

Choose one... Female Male Non-binary Transgender Prefer not to disclose

Race/Ethnicity

Do you want to become a member of The Arc of Spokane? When you sign up to be a member of The Arc of Spokane, you are saying “Count me in - I’m an advocate for disability rights!” Membership matters because it makes clear to our elected officials and community partners that we are advocating on behalf of an extended community of family members, self-advocates, and supporters of disability rights in eastern Washington and beyond.

I would like to become a member of The Arc of Spokane

We will never share your email address. Ever.

ORGANIZATION NAME
ORG ADDRESS LINE 1 ORG ADDRESS LINE 2
ORG CITY, ORG STATE ORG ZIP
ORG CONTACT PHONE
ORG CONTACT EMAIL

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ORGANIZATION NAME
ORG ADDRESS LINE 1 ORG ADDRESS LINE 2
ORG CITY, ORG STATE ORG ZIP
ORG CONTACT PHONE
ORG CONTACT EMAIL

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Public Name
Start Date
Venue Name
Event Address Line 1 Event Address Line 2 Event City, Event State

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ORGANIZATION NAME
ORG ADDRESS LINE 1 ORG ADDRESS LINE 2
ORG CITY, ORG STATE ORG ZIP
ORG CONTACT PHONE
ORG CONTACT EMAIL

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ORGANIZATION NAME
ORG ADDRESS LINE 1 ORG ADDRESS LINE 2
ORG CITY, ORG STATE ORG ZIP
ORG CONTACT PHONE
ORG CONTACT EMAIL

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Instagram

YouTube

Take Action

Sorry, we're not targeting any representatives in your district. But, you can still help!

Edit this message to tell users that can't take action (because of their location) how to contribute. For example, consider adding a link to a petition or donation page that you have created, or add social sharing options so that these supporters can help get the word out on social media.

ORGANIZATION NAME
ORG ADDRESS LINE 1 ORG ADDRESS LINE 2
ORG CITY, ORG STATE ORG ZIP
ORG CONTACT PHONE
ORG CONTACT EMAIL

Facebook

Instagram

YouTube

ORGANIZATION NAME
ORG ADDRESS LINE 1 ORG ADDRESS LINE 2
ORG CITY, ORG STATE ORG ZIP
ORG CONTACT PHONE
ORG CONTACT EMAIL

Facebook

Instagram

YouTube

Thank you for signing up for The Arc's Spokane County Parent Coalition.

If you have advocacy questions, please contact us at advocacy@arc-spokane.org or (509) 789-8797.

Thank you for signing up!

Contact Us

ORGANIZATION NAME
ORG ADDRESS LINE 1 ORG ADDRESS LINE 2
ORG CITY, ORG STATE ORG ZIP
ORG CONTACT PHONE
ORG CONTACT EMAIL

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YouTube