District Barrier Identification Form The Delta School District is committed to fostering an inclusive and accessible environment for all students, staff, families, and community members. This form is intended to help identify barriers that may limit equitable access to district facilities, programs, services, or information. Your feedback will support our ongoing efforts to remove barriers and improve accessibility across the district. We appreciate you taking the time to share your experience and suggestions. Question 1I am a:* Student Parent/Guardian Staff Community Member Other Question 2Do you identify as a person living with a disability?YesNoQuestion 3Experience with Barrier: I experienced this barrier personally I am submitting this on behalf of an individual who has experienced or may experience this barrier. Question 4Please select the location where the barrier is located (check all that apply):Annieville ElementaryBeach Grove ElementaryBoundary Beach ElementaryBrooke ElementaryChalmers ElementaryCliff Drive ElementaryCougar Canyon ElementaryDevon Gardens ElementaryEnglish Bluff ElementaryGibson ElementaryGray ElementaryHawthorne ElementaryHeath ElementaryHellings ElementaryHolly ElementaryJarvis Traditional ElementaryLadner ElementaryMcCloskey ElementaryNeilson Grove ElementaryPebble Hill Traditional ElementaryPinewood ElementaryPort Guichon ElementaryRichardson ElementarySouth Park ElementarySunshine Hills ElementaryBurnsview SecondaryDelta SecondaryDelview SecondaryNorth Delta SecondarySands SecondarySeaquam SecondarySouth Delta SecondaryDelta Manor Education CentreDelta Community CollegeSchool Board OfficeTilbury Maintenance OfficeQuestion 5Select the type of barrier:Physical Barrier - online platform, software, or device that is not designed to be usable, such as websites without screen reader compatibility or videos lacking captionsDigital/Technological Barrier - online platform, software, or device that is not designed to be usable, such as websites without screen reader compatibility or videos lacking captionsCommunication/Informational Barrier - obstacles that prevent clear understanding or information exchange, such as the absence of sign language interpretation, inaccessible written materials, or unclear visual or auditory informationProcedural/Policy Barrier - any rule, practice, or process that unintentionally limits participation or accessAttitudinal Barrier - any prejudice, bias, or misconception that limits opportunitiesOther BarrierQuestion 6Barrier Description - Please describe the barrier and indicate whether it involves equipment, technology, a policy, or a procedure. Please include as much detail as possible to help us understand the concern.Question 7Impact (optional) - Please describe how this barrier affects access to facilities, programs, services, or information.Question 8Additional Comments (optional):Contact Info (optional)If you choose to include contact information, it will be kept confidential and will only be used if additional information is needed to better understand the barrier described.Contact:
