Advocacy

Are you interested in self-advocacy or in being an advocate for people with disabilities? CIL wants to know about your interest in issues effecting people with disabilities. Tell us a little bit about yourself.

You may download the following Microsoft Word document, print it and mail it in to CIL or...

...fill out and submit this online form. If you want to know more, please call CIL at 407-623-1070.

NOTE: "Name" and "Email Address" fields are required.

Personal Details

Address and Street

City   State Zip Code

Home Phone  Work Phone 

Cell Phone 

Email Address  Age

Interests and Skills

Areas of Interest (please check all that apply)
 I want to be kept informed. Please add my name to your mailing list.
 I'll attend an event
 I'll write a letter
 I'll make a phone call

Special Skills or Knowledge 

How did you hear about CIL? 

Submit

Thanks very much for your interest in CIL. Please click the SUBMIT button once. Someone will contact you in the near future.