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Thank you for interest in applying for the Disability Community Liaison opportunity through Texas A&M AgriLife Extension Service and the Texas Council for Developmental Disabilities. Please fill out the information below for consideration of your application.

Please provide your full name (first and last name):

Please provide your email address:

County (provide in box):

Which category describes you? (Check all that apply)

I have a disability.
I am a family member of a person(s) with a disability.
Neither

Please select your role (Check all that apply)

Self-advocate
Parent
Caregiver or support person
Service Provider
Educator or other school support
Other (Please specify)

Please describe the refugee population you are connected to. Please describe details about the organization or agency that works closely with this group.

A community conversation is an informal dialogue designed to engage members of a community in meaningful discussion about issues, concerns, or topics that impact them. Please describe your experience with conducting community conversations to engage communities and collect information.

Will you be able to commit to completing a community conversation by July 31, 2024?

Yes
No