Access Request Form

This access request form is to be completed by a conference or event delegate / attendee who requires accessibility accommodation at a CUPE Ontario Event.

Please only complete this form if you are the event attendee, and you are requesting an accessibility accommodation.

This form must be submitted at least 30 days prior to the start of the event.

Note: You must complete this form if you require ASL Interpretation or French language interpretation.

“If your event is at the Sheraton Centre Toronto, please be mindful that there is a distance to travel from one room to another, and note that the floors are carpeted, which may create some challenges in maneuvering when using a manual wheelchair.”

Your Name *

Local Number *

Conference / Event NameFall SchoolSpring SchoolIW & HS ConferenceHCWCC Conference Racial Justice & Human Rights Conference Women’s Conference Trades ConferenceSecretary Treasurer ConferenceOUWCC ConferenceOSBCU ConferenceSSWCC ConferenceOMW ConferenceCUPE National ConventionCACO CaucusClimate Justice ConferenceRetiree Network MeetingOther

Conference / Event name *

Street Address *

Apartment, suite, etc

City *

Province *

Postal Code *

Your Email Address *

Preferred Phone *

Alternate Phone

Preferred Language *Please select...EnglishFrançais

Hotel Room Accessibility Requests

Your Hotel Room Accessibility Requests:

Physically Accessible Room (including a roll in shower)Visually Accessible Room for D/deaf & HoH guestsUnscented product use

Event Access Requests

Do you require ASL at the event?YesNo

Are you a French speaker who requires interpretation into French at the event?YesNo

Your Event Accommodation Requests:

Dietary Restrictions/AllergiesAccessible SeatingOffice chairScooter rentalSign Language InterpretationFrench TranslationOther

Specific details about your request

Submit form