USA Toolkit 1.02 - Pre-Authorization

USA Toolkit 1.02 - Pre-Authorization

to DISTRIBUTE and/or USE the USA - Iowa TOOLKIT

You must get PRE - AUTHORIZATION from PADS to COPY, DISTRIBUTE, and/or USE the USA - Iowa TOOLKIT (in total or in part).

NOTE: For - profit groups may be required to pay a fee for the use and distribution of the TOOLKIT .

NOTE: Non - profit groups & organizations 501 ( c ) 3 may be able to use the TOOLKIT FREE if the intent is distribution to, or use with, people with disabilities.

For PRE - AUTHORIZATION questions, contact:
Cherie Clark - PADS Charter Member
power2pwd@yahoo.com
319 - 364 - 0037


We ask that you do two things:

  1. Complete the short form from the PDF version of this Pre-Authorization document or refer to the needed information listed below in this HTML document. Send your request with needed information to Cherie Clark
    via U.S. Mail:
    Cherie Clark
    PADS - TOOLKIT Request
    P.O. Box 883
    Cedar Rapids, IA 52406 - 0833
    Or Scan it and Send via E-Mail:
    Cherie Clark
    power2pwd@yahoo.com
    Subject: PADS - TOOLKIT Request
  2. When you distribute or use the TOOLKIT, you must acknowledge PADS (Peer Action Disability Support) and the originators of the pages (in the footnotes of each page).

When you plan to use or distribute the TOOLKIT (the entire document or just a few pages), please get PRE - AUTHORIZATION by completing this form and mailing it to the address on the page before or scanning the completed form to power2pwd@yahoo.com


NAME OF PERSON/ORGANIZATION: ____________________ ____________________
ADDRESS: ___________________________________________________________
CITY/STATE/ZIP+4: ____________________________________________________
PHONE NUMBER: ____________________________________________________
E-MAIL ADDRESSES: __________________________________________________

Are you
__a 501(c)3 non - profit ?
__A free - standing self - advocacy group?
__For - profit group?
__An individual passing info on to others
 
__About how many people with disabilities will see or get the TOOLKIT information? (it is OK to estimate)
 
What kind of info rmation do you want give them from the TOOLKIT?
__Pages from t he SECOND PART dealing with ADVOCACY - Self - advocacy & community advocacy
__Pages from t he THIRD PART dealing with LEADERSHIP - In meetings and in the community
__Pages from the FOURTH PART is RESOURCES
__The entire TOOLKIT
 
__How many people will get the pages from the TOOLKIT ?
 
What will be their general age ranges?
__Teen to young - adults
__Adults
__Young - seniors
__Older - seniors
 
Who will get the TOOLKIT information?
__People with physical disabilities
__People with s ensory disabilities
__People with i ntellectual disabilities
__People with m ental illness
__People with serious health conditions
__Parents & family members, service providers, vendors, etc.
__Policymakers, funders, business people, community members , etc.

We thank you for your interest in the USA - TOOLKIT !