Form Builder

Required fields are marked with asterisks (*)

Accessibility for Ontarians with Disabilities Act Compliance Statement

The undersigned has reviewed the Town of Aurora Accessible Customer Service for Persons with Disabilities – Policy No. 63, Integrated Accessibility Standards Policy – Policy No. 69 and Guide for An Accessible Aurora on the Accessibility in Aurora webpage in accordance with the Integrated Accessibility Standards Regulation (O. Reg. 191/11) of the Accessibility for Ontarians with Disabilities Act, 2005 (AODA).

The undersigned acknowledges that the work/services being performed on behalf of the Town of Aurora will be in accordance with the provisions and regulations of the Accessibility for Ontarians with Disabilities Act, 2005 (AODA).

First Name

Last Name

Phone Number

Email Address

Role

Contractor

Staff

Volunteer

Department

By entering my initials below, I certify that this is an acceptable form of my signature.

For questions about this form please contact the Town of Aurora's Accessibility Advisor at (365) 500-3172 or accessibility@aurora.ca .