Sample registration form

The following are sample questions that can be used as part of a registration form. Helpful hints for preparing the form are in brackets. This form is based on a compilation provided by the International Disability Alliance (IDA).

Primary information questions

  • First name (insert text field)
  • Family name (insert text field)
  • Email address (insert text field)

Recommended disaggregated information questions 

These questions help collect data related to underrepresented groups and participant demographics

  • What is your country of origin? (written field or dropdown menu of countries)
  • Do you consider yourself to be: (check-box option) (recommended mandatory question)
    • A man
    • A woman
    • Other
    • I prefer not to say
  • Do you consider yourself to be: (check-box option) (recommended mandatory question)
    • A person with intellectual disability
    • A person with autism
    • A person with deafblindness
    • A person with psychosocial disability
    • A person who is blind or partially sighted
    • A person with physical impairments
    • A person who is deaf
    • A person who is hard of hearing or has other hearing impairments
    • A person with another disability not yet mentioned
    • A person without disability
    • A family member of a person with disability
    • I prefer not to say
    • If you answered 'A person with another disability not yet mentioned' please describe (written field)
  • What is your age? (check-box options)
    • 18 and under
    • Between 19 and 35
    • Between 36 and 55
    • Between 56 and 64
    • Between 65 and 74
    • 75 and over
    • I prefer not to say
  • Do you identify as an indigenous person and/or a person from an ethnic or racial minority? (check-box option)
    • Yes
    • No
    • I am not sure
    • I prefer not to say
  • What type of organisation do you belong to? (check-box option)
    • Organisation of Persons with Disabilities
    • Government
    • United Nations
    • Non-governmental Organisation
    • Consultant
    • For-profit organisations
    • Other
    • I do not belong to an organisation
    • I prefer not to say
    • If you answered 'Other' please describe (written field)
  • Do you require any reasonable accommodation to ensure your participation in the event? (written field)

Download this 'Sample registration form for meetings'.


Supporting material