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APPLICATION FORM: DISABILITY INCLUSION FACILITATORS Return the completed application form to Erna Miller at Erna TLM.co.ZA no later than 19 May 2017 1 IDENTIFICATION DETAILS 1.1 Surname: 1.2 First

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Read the instructions carefully before filling out the application form for disability inclusion.

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Gather all necessary documents and information, such as medical records and personal identification.

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Start by providing your personal details, including your name, address, contact information, and date of birth.

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Fill out the sections related to your disability, including the type of disability, its impact on your daily life, and any additional support or accommodations needed.

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If applicable, provide details about your previous work experience and education.

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Include any supporting documents, such as medical certificates or assessment reports, that verify your disability.

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Review the form thoroughly to ensure accuracy and completeness.

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Submit the application form along with any required documents to the designated authority or organization.

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Keep a copy of the completed form for your records.

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Follow up with the concerned authority to check the status of your application and address any further requirements.

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Individuals with physical, sensory, intellectual, or mental health disabilities can utilize this form.

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The application is designed to assist individuals in accessing appropriate resources, services, and accommodations based on their specific disabilities.

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This form is beneficial for individuals seeking assistance in employment, education, healthcare, transportation, and various other areas of life.

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