Accessibility Inquiry Form

2. First name*

3. Last name*

5. Address*

7. City*

8. State*

9. Zip*

11. Phone number*

12. Email*

14. Classification of Accessibility /Concern/Inquiry (Choose all that apply)*

    1. Public Right-of-Way (Sidewalks, Street, Curbs, Signage, Traffic Control, Lighting, Parking)
    2. Town Public Facilities (Parking, Routes, Building Entry, Signage, Restrooms, Services, etc)
    3. Town Public Services or Programs (Parks, Theaters, Aquatics, Athletic Facilities, Signage, etc)
    4. Town of Normal Website Accessibility and Navigation
    5. Private Commercial/Business Facilities (Parking, Entry, Restrooms, Signage, Goods and Services)
    6. Private Housing (Parking, Accessible/Adaptable Units, Signage, Tenant Accommodations, etc)
    7. Other Questions or Concerns Not Listed

16. If other, please specify*

18. Specific Location or Address in Normal, IL if known*

20. Please give details about your experience*

22. Thank you for your feedback
    Your form will to submitted to the ADA Coordinator and the appropriate department contact person. Should you have further questions, please contact:<br> ADA Coordinator <br> Greg Troemel, Town of Normal<br> #11 Uptown Circle<br> Normal, Illinois 61761<br> Phone: 309-454-9580<br> gtroemel@normal.org

    Your form will to submitted to the ADA Coordinator and the appropriate department contact person. Should you have further questions, please contact:
    ADA Coordinator
    Greg Troemel, Town of Normal
    #11 Uptown Circle
    Normal, Illinois 61761
    Phone: 309-454-9580
    gtroemel@normal.org

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24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

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