The Information Society disAbilities Challenge

Application Form * Due to privacy reasons you can choose not to give us some information we ask you. We respect that. Information regarding your disability is however important to us because some tests are only for people with a specific disability, so we don’t have to overload your mailbox if you don’t qualify for certain tests.
First Name:
Surname:
E-mail:
Password:
Country:
Gender:	Male Female
Age:
Disability:
Additional info regarding disability:
Highest Education:
Additional info regarding education:
Professional status:
Native language:
Other languages that you are familiar with (please check) :	English French Dutch German Spanish
Other Languages spoken:
Do you use assistive technology to access the computer?	Yes No
Which assistive technology do you use? (please check)	Screen reading-enlarging software Braille display Alternative keyboard Speech synthesis Speech recognition Alternative mouse Text phone software Sound amplifier
Other assistive technology:
How would you describe your internet skills:	Beginner Intermediate Expert
Is the internet sufficiently accessible for you?	Yes No
Which problems do you encounter accessing the internet?
How did you hear about ISdAC and the user database?
Do you have any other remarks/suggestions?

http://isdac.org/en/user.php
23.September.2004