Institute on Disabilities Consumer Advisory Committee Nomination Form

Complete the online form below, OR download, complete, print and mail (directions included on paper form).

Downloadable nomination form (Word)

The Institute on Disabilities at Temple University is seeking nominations for members of its Consumer Advisory Committee (CAC). The CAC is comprised of a majority of people with developmental disabilities and family members of such individuals, representatives of key agencies, and other stakeholders as specified in the Developmental Disabilities Act (DD Act; ).

According to the DD Act, the primary purposes of the CAC are to consult with the Institute leadership regarding the development of the five-year plan, participate in the annual review of progress toward the goals in the plan, and to make recommendations regarding any proposed revisions that are necessary.

The CAC serves as a liaison between the Institute and the community, promoting and sharing the Institute's mission. Although the CAC is "advisory" and does not influence decisions regarding financial or personnel issues, input is seriously considered by the Executive Director(s).

CAC members are expected to:

  1. Attend and actively participate in CAC meetings (held at least twice a year);
  2. Participate in the identification and exploration of new opportunities for funding, within the scope of our mission and vision, and especially those involving partnerships with diverse stakeholders;
  3. Assist in educating others about the programs, publications, and other resources available through the Institute;
  4. Advocate for the establishment/maintenance/improvement of state and federal laws, policies, and appropriations, which support the Institute's mission and improve the lives of individuals with developmental disabilities.

PLEASE NOTE: All nominees must reside in in the Commonwealth of Pennsylvania.

The Institute is committed to the provision of reasonable supports and services to promote full, meaningful participation of individuals with disabilities and family members who serve on the CAC, including but not limited to reimbursement of travel expenses (in accordance with Temple University policies), alternate formats, assistance with reading/understanding materials, interpretation services, etc. Stipends may also be available under certain circumstances. One of the Institute's goals is to develop structures that will enable the CAC to be self-governing.

Why consider joining the CAC? Participation in the Institute CAC is a leadership opportunity for members as disability advocates and mentors. The CAC brings together decision-makers and people with different ways of looking at issues.

Questions? For more information, contact us at 215-204-1356 (voice), 215-204-1805 (TTY), or

Nomination FORM - must be completed by September 15, 2013

Items marked with * are required.

Nominee Information

Nominator Information (if other than self)

*Is the nominee aware of this nomination?
*Is the nominee a person with a disability?
If yes, is the disability a developmental disability as defined by the DD Act?
*Is the nominee a family member of a person with a disability?

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