ADA Digital Accessibility Issue Form

ADA Digital Accessibility Issue Form

Please complete the below form and submit. All required fields are noted with a red *. If you are unable to complete the form, please contact ADA@ncseaa.edu.

Last Name*

First Name*

Middle Name (Optional)

Date Digital Accessibility Issue Occurred

What was the date you accessed the website or attempted to contact SEAA?

Describe Digital Accessibility Issue*

To the best of your recollection, please outline the issue(s) you experienced while attempting to navigate the SEAA website or when attempting to contact our office. Please provide any relevant website urls or phone numbers if available.

URL of Digital Resource

Have you submitted this complaint prior?*

Yes

Details of Prior Complaint (Optional)

If you answered "Yes" to the question above, please describe when and to whom the initial complaint was submitted.

Phone Number *

Phone

Email Address*

Supporting Documents

Upload any additional information that you believe will be helpful for us to understand the digital accessibility issue that you experienced.

**Please do not include any personal identifying information including social security numbers, birth date, or any other sensitive information not included on this form.**

Drag and drop files here or

Send me a copy of my responses

Privacy Notice|Report Abuse