attachment for Accessibility of Online Services and Merchants for Deaf / Hearing-Impaired Consumers

Here is the “attachment’ for the last email
 
Gregg
 
Brief Example of an Web Form that Helps to Identify How Deaf /
Hearing-Impaired 
Consumers Should be Contacted

(Go back go the Suggestion Memo: deafhh_w3csuggestion.htm)


Name
 
 

Address
 
 

Address
 
 

City
 
 

State
 -- Select a State --    Alabama    Alaska    Arizona    Arkansas
California    Colorado    Connecticut    Delaware    District of
Columbia    Florida    Georgia    Hawaii    Idaho    Illinois    Indiana
Iowa    Kansas    Kentucky    Louisiana    Maine    Maryland
Massachusetts    Michigan    Minnesota    Mississippi    Missouri
Montana    Nebraska    Nevada    New Hampshire    New Jersey    New
Mexico    New York    North Carolina    North Dakota    Ohio    Oklahoma
Oregon    Pennsylvania    Rhode Island    South Carolina    South Dakota
Tennessee    Texas    Utah    Vermont    Virginia    Washington    West
Virginia    Wisconsin    Wyoming    

Zip
 
 

E-mail Address 
 
 

Home Phone
    Voice  TTD 

Work Phone
    Voice  TTD

Fax
 
  
 

Wireless 
Device / Pager
 
 This is 2-way text device

Preferred way to 
be contacted
 -- Select One --    Phone (Voice)    Phone (TTD)    E-mail    Wireless
Device    Fax    
 
For Comments, suggestions, I can be contacted at Moorela@Ameritech.Net
<mailto:moorela@ameritech.net?subject=W3C%20Comments>