ID card application

1

PLEASE NOTE:

All ID cards currently take 21- 30 WORKING DAYS to be issued.

Please be careful when both uploading information and choosing the photo as this will be automatically printed on the card.

ASD Ireland takes no responsiblity for incorrect information been submitted
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Read and follow the instructions carefully prior to submitting your application. incomplete applications will not be processed and may result in delays. Cards are issued with 21-30 working days. Please ensure that the documents required are submitted with the application otherwise this may lead to delayed issuing of your card.
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Your name* This field is required.
First Name
Last Name
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Full Name of Person with autism * This field is required.(will be printed on the card)
First Name
Last Name
5
Date of birth:* This field is required.of the person that requires the card
Day
Month
Year
6
Date of birth of the person with autism * This field is required.
Date
Day
Month
Year
7
Mobile No. :* This field is required.
Area Code
Phone Number
8
Home Address :* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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E-mail :* This field is required.Please indicate correct E-mail as your confirmation for eligibility will be sent to this address.
Where the confirmation will be send to
10
I consent to my personal/health information being collected and processed to verify your/ your Childs diagnosis< This information will be processed in Line with GDPR regulations and will not be shared. * This field is required.Please note if you select no an an application cannot be processed and ID card issued
YESNO
11
Evidence of diagnosis * This field is required.1. Please ensure to upload supporting evidence of diagnosis. in the form of EI or private diagnosis , school letter or GP letter, document must state diagnosis of autism
Drag and drop files here
Select files to upload
Cancelof
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Photo of person with autism * This field is required.Please Note: photo must be front facing, colour with no filters .. ASD Ireland are not responsible for any photo you upload , it will be printed exactly as it is supplied. Do not submit photos of photos .
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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By signing (typing your legal name) in the space below, you are certifying that all information is correct and that you are the person completing this application. When you press the submit button, you will receive an email confirmation that your application was received. Please print for your records and retain as verification of your application.
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E-Signature:* This field is required.
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Autism ID card* This field is required.
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