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ADDRESS: |
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ZIP: |
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DAYTIME PHONE/TTY: |
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EVENING PHONE/TTY: |
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E-MAIL ADDRESS: |
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In an average week, how many times do you ride? |
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What do you think of the service provided to you? |
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By Metrobus: |
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By MetroAccess:
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What improvements would you recommend? |
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Why do you use Metrorail, Metrobus or MetroAccess? |
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Which best describes your race and/or ethnic background? (optional) |
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Do you use e-mail? |
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What level of education have you completed? |
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- DESCRIBE
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- DESCRIBE
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In what area(s) or way(s) can you provide a personal perspective or personal point of view? |
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Is anyone in your household a party to either a lawsuit against Metro or a contract with Metro? |
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Please provide a brief statement (3000 characters or less) outlining why you wish to serve on the WMATA Accessible Advisory Committee. Include your community involvement/volunteer activities/membership with disability or senior organizations. |
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Do you have any experience and familiarity with regional transit issues? |
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Do you have any experience advocating for issues concerning persons with disabilities and senior citizens? |
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Please describe (3000 characters or less) how you-as a member of the WMATA Accessible Advisory Committee-would solicit feedback from fellow Metro riders. |
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List your organizational affiliations/memberships: |
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Normally, the commitment to the committee will require 4-5 hours per month. Can you commit 4-5 hours per month to the committee? |
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The committee meets the first Monday of every month from 5:30 - 7:30 p.m.
Can you meet at this time? |
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Metro may use or disclose the individual information collected on this form to fill positions on the Accessibility Advisory Committee. Providing this information is voluntary, but an individual who does not provide the information may not be considered as a candidate for membership on the Accessibility Advisory Committee.
Information from this form may be disclosed for law enforcement purposes; to congressional offices or offices of elected officials in the Transit Zone; to contractors, grantees and others; for administrative claims, complaints and appeals; and in connection with litigation.
Selected information about Accessibility Advisory Committee members may be disclosed to the public. By signing this application, I swear or affirm that 1) I am not an employee of Metro or a Metro contractor, 2) I am not an elected public official, 3) all of the information provided here is true, 4) if selected, I will sign a standards of conduct agreement, 5) I will have sufficient time to devote to this responsibility, and 6) I will commit to attend the required meetings. |
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