Welcome to the IATP Maker Program

Item Request

Fabricated Assistive Technology

Device Name *

Please provide a title for the device. If the device does not have a name, provide something descriptive.

Device Description *

What will you use the device for?

Please describe any related devices you have attempted to use and the limitations of those devices. *

Please upload an image or drawing that might aid in the design process.

Drop a file here or click to upload Choose File

Maximum file size: 15MB

Main Contact

First Name *

Last Name *

Email *

Phone Number *

Are you an IATP Employee? *

Yes

No

Please select department ISBEICCReuseDevice LoanTech KitchenOther Please select department

Customer Information

Same as Main Contact? *

Yes

No

First Name *

Last Name *

Email

Phone Number

County * Adams CountyAlexander CountyBond CountyBoone CountyBrown CountyBureau CountyCalhoun CountyCarroll CountyCass CountyChampaign CountyChristian CountyClark CountyClay CountyClinton CountyColes CountyCook CountyCrawford CountyCumberland CountyDeKalb CountyDeWitt CountyDouglas CountyDuPage CountyEdgar CountyEdwards CountyEffingham CountyFayette CountyFord CountyFranklin CountyFulton CountyGallatin CountyGreene CountyGrundy CountyHamilton CountyHancock CountyHardin CountyHenderson CountyHenry CountyIroquois CountyJackson CountyJasper CountyJefferson CountyJersey CountyJo Daviess CountyJohnson CountyKane CountyKankakee CountyKendall CountyKnox CountyLake CountyLaSalle CountyLawrence CountyLee CountyLivingston CountyLogan CountyMacon CountyMacoupin CountyMadison CountyMarion CountyMarshall CountyMason CountyMassac CountyMcDonough CountyMcHenry CountyMcLean CountyMenard CountyMercer CountyMonroe CountyMontgomery CountyMorgan CountyMoultrie CountyOgle CountyPeoria CountyPerry CountyPiatt CountyPike CountyPope CountyPulaski CountyPutnam CountyRandolph CountyRichland CountyRock Island CountySaline CountySangamon CountySchuyler CountyScott CountyShelby CountySt. Clair CountyStark CountyStephenson CountyTazewell CountyUnion CountyVermilion CountyWabash CountyWarren CountyWashington CountyWayne CountyWhite CountyWhiteside CountyWill CountyWilliamson CountyWinnebago CountyWoodford County

*The Maker Program is offered to Illinois residents only.

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Terms and Conditions *

I Agree

ELIGIBILITY: By using our website, you warrant that you are 18 years of age or older and have the legal authority to enter into these Terms.
RELEASE OF LIABILITY: I agree to indemnify and hold harmless the Illinois Assistive Technology Program, the IATP Maker Program, and any and all employees, agents or representatives of same, from damages to property or injuries to myself, and/or any other person, and any other losses, damages, expenses, claims, demands, suits and actions by any party against above stated entities, in connection with fabricated devices from IATP Maker Program.
RESPONSIBILITY AND LIABILITY: I understand and agree that I am responsible for the proper handling, storage, use, care, and maintenance of the device(s), component(s), or accessory(ies) given to me hereunder. In the sole discretion of the IATP Maker Program, and any and all employees, agents or representatives of same, my ability to further participate in any such projects, programs, grants, or loans from IATP Maker Program and all of its related programs may be suspended for a period of time or indefinitely for failure to abide by project rules.

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