PEERS for Adolescents March 3rd - June 16th
Weekly virtual meeting Wednesdays from 5:30-7pm
Full Name
*
Date of Birth
*
DDS Eligibility:
*
DDS
Autism Division
Parent's Name
*
Address
*
Town
*
Zip Code
*
Contact Number
*
Email Address
*
Allergies/Medical Conditions
*
Do you understand that you or another parent must also attend all sessions as the "Social Coach:"
*
Yes
No
Please list 3 extracurricular activities your teen is interested in
*
What social aspects does your teen struggle with the most
*
Are there any types of supports that are helpful working with your teen (ie, visuals, schedules, timers, etc.)
*
I give Community Autism Resources permission to have myself, my family members, or any person(s) that I have registered for this Event to be photographed/videotaped for educational/publicity purposes only:
*
Yes
No
Submit
Should be Empty: