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English (US)
Spanish (Latin America)
ASGNO Virtual Program Sign Up Form
Fill out the information below to enroll in as many programs as you are interested in attending to receive the meeting information. You are signing up for all meeting dates through June, you do NOT need to sign up each month.
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Parish/County
*
Select all programs you are signing up for
*
Caregivers of High Support Needs Children / Individuals
Caregivers of Low Support Needs Children / Individuals
Spanish Speaking Caregivers / Cuidadores de habla hispana
Sibling Support Group
Kids Play Group (ages 5-8)
Pre-Teen Social Group (ages 9-12)
Adult Social Group (Ages 18+)
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Caregivers Support Groups Additional Questions
What do you feel is your greatest need currently as a caregiver
How old is/are your child(ren)?
Sibling Support Group Additional Questions
Meets the Fourth Monday of each month at 6:00 PM. This group is ONLY for siblings ages 10 and up of individuals with autism. Adult supervision is required for participants ages 10-12.
Names and ages of all siblings you are enrolling
Pre-Teen Social Group (Ages 9-12) Additional Questions
Meets the Third Thursday of the month at 6:00. This program is for Pre-Teens with autism, Adult supervision is required during participation.
Names and Ages of all Children you are signing up for the Pre-Teen Social group
Kids Play Group (Ages 5-8) additional Questions
This program is for kids ages 5-8 with autism, adult supervision is required during participation
Names and Ages of all Children you are enrolling in the Kids Play Group
Which Dates are you signing up for?
April 10th-Wild About Animals
May 1st-Astronaut Space Adventure
June 5th-StoryTelling
If you are interested in applying for a hardship scholarship after your first meeting please click here and pay only for the first meeting you plan to attend in the payment portal below.
I am interested in applying for a hardship scholarship
I am not interested in applying for a hardship scholarship
Registration Fee Payment-You will be redirected to PayPal after submitting the form to complete your payment.
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April 10th-Wild About Animals
Registration Fee for one Kid's Playgroup meeting
$
5.00
Number of Children
Item subtotal:
$
0.00
May 1st-Astronaut Space Adventure
$
5.00
Number of Children
Item subtotal:
$
0.00
June 5th-StoryTelling
$
5.00
Number of Children
Item subtotal:
$
0.00
Adult Social Group Additional Questions
Meets the second and fourth Thursday of the month at 7:00 PM. This group is ONLY for adults (18+) with Autism.
Would you like a reminder texted to you at the Phone number provided above before each meeting?
Yes
No
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