World Disability Union | Evaluation Request Form

Evaluation Request Form

We kindly ask you to send your assessment committee to assess the environmental facilities for people with disabilities in our building.

Organization Name:

Type of Organization:

Government

Private Sector

Non-Government

Other

Building Type:

Country/City Name:

Scope of work of the Institution:

Name of the Head of the Institution:

Website:

Email:

Phone:

Whatsapp:

Uploads:

Picture of Building Plan

Picture of Ramps for People with Disabilities

Picture of Bathrooms for People with Disabilities

Picture of Elevators if any

Picture of Reception if any

Picture of any service provided to People with Disabilities

* Allowed File size 1MB and JPEG/JPG/PNG/PDF only

Applicant Name:

Occupation:

Mobile Number: