The Neurodivergent Collective

The Neurodivergent Collective

Interest Form
This form is for anyone interested in attending the Neurodivergent Collective events.
The Neurodivergent Collective Mission Statement

The Neurodivergent Collective is a community by and for neurodivergent people. Join our welcoming community to access inclusive opportunities for connection! We hold events and meetups for anyone over the age of 18 and identifies as neurodivergent (ADHD, Autistic, OCD, Dyslexia etc). We have volunteers facilating events but do not provide direct support or supervision. Members bring their own supports to help adapt and accommodate their needs.
Who is filling out this form?

I am interested in attending and I am filling out this form for myselfMy adult son or daughter is interested in attending and I am filling out this form with themMy adult son or daughter is interested in attending and I am filling out this form on behalf of them
Name of Person Interested in attending

First NameLast Name
Birth Date of person interested in attending

MonthDayYear
Date
Name of person filling out this form

First NameLast Name
Email Address of person filling out this form
example@example.com
Phone Number of Person Filling out this form
Please enter a valid phone number.
Availability
These events may be held in the late afternoon or the evenings. When are you generally available to attend?

weekdays 6:30pm - 8:30pmweekdays 4pm - 6pm
These events may be held in different days of the week. In general which days are you able to attend?

MondaysTuesdaysWednesdaysThursdaysFridays
Currently we plan to hold events on weekdays. If we held events in the future on weekends would you be interested in attending?

Yes Saturday onlyYes Sunday onlyYes both weekend says would be fineNo, I can't come on weekends
In the future if we held meetups where members could come meet up at the same event would you be interested? The events would be in the central NJ area. You would need your own transportation to get there and back. You would need to pay for the event if there is a fee attached. Example: we meet up at a screening of a movie at the local movie theater

Yes I would be interested in meetupsNo I would not be interested in meetups
If you answered NO I am not interested in meetups can you explain why that wouldn't be something that you are interested in? (cost, transport, other barriers, or lack of interest...etc)
Questions
These events do not have RCAAS staffing and do not provide direct supervision of participants. There will be event facilitators to answer questions and give guidance but participants are expected to be able to navigate the activities and building independently. Please select from below which statement applies to you or the person you are filling this form in for.

I am able to attend these events without support and supervisionI will need support and supervision at this events and will bring someone with me to provide that support and/or supervision. (This could be a family member, friend, peer mentor, guardian, support staff...)
There will be a variety of independent activities, opportunities to join others in on board games or video games, and structured activities like bingo or trivia. How do you like to participate? You can select more than one answer.

I like coming for a structured activity like a cooking activity or a fitness classI like to come to meet people in a casual way and it's not as important to me what the activities areI have certain activities that if I know they are available I would come to do (example a movie night or video games)I like to be around other people but I am more of an observer than wanting to join inI enjoy joining in activities with othersI prefer to be quiet when doing activitiesI like to talk to others when doing activitiesI would like to come to do an activity independently like a puzzle or read a bookI like discussions on topics that are structured
Please Rate your Interests below

on a scale of 1 (not interested) to 5 (very interested)
Art Projects

1

2

3

4

5

1 is Not Interested , 5 is Very Interested
Fitness or Wellness Activities

1

2

3

4

5

1 is Not Interested , 5 is Very Interested
Making Music

1

2

3

4

5

1 is Not Interested , 5 is Very Interested
Dancing

1

2

3

4

5

1 is Not Interested , 5 is Very Interested
Board Games

1

2

3

4

5

1 is Not Interested , 5 is Very Interested
Peer Support Groups

1

2

3

4

5

1 is Not Interested , 5 is Very Interested
Discussion Based Special Interest Groups

1

2

3

4

5

1 is Not Interested , 5 is Very Interested
Cooking activities

1

2

3

4

5

1 is Not Interested , 5 is Very Interested
Video Gaming (x box, play station)

1

2

3

4

5

1 is Not Interested , 5 is Very Interested
Meet Ups in the Central NJ area

1

2

3

4

5

1 is Not Interested , 5 is Very Interested
Movies

1

2

3

4

5

1 is Not Interested , 5 is Very Interested
Karaoke

1

2

3

4

5

1 is Not Interested , 5 is Very Interested
Trivia

1

2

3

4

5

1 is Not Interested , 5 is Very Interested
Hands on activities/ making things

1

2

3

4

5

1 is Not Interested , 5 is Very Interested
What kind of movies do you like? Or list some favorite movies.
What kind of video games or board games do you like to play?
Please write what other interests you may have
Is there anything else you would like us to know about you or the person you are filling this form out for?
Thank you for your interest in attending the Neurodivergent Collective. I will be in contact shortly.

- Elizabeth Dicker, Accessibility Specialist RCAAS
Should be Empty:

The Neurodivergent Collective

The Neurodivergent Collective Mission Statement

Availability

Questions