Youth Adult Activity Suggestion


Feel free to use the link above to the form or answer the questions below.  Replies should be sent to  Hard copies can also be left at the Chapter office.

Self-advocates, family members, volunteers, and community service providers can submit ideas.  All suggestions will be reviewed by the Kingston Chapter Leadership Council.  Please complete all sections to the best of your ability.  Feel free to contact the Chapter office for assistance.


My name is


I can be reached at (if we would like more information)

  • Phone
  • Email
  • Other

My idea is...

(Please use the back or another paper if needed.)




This activity is for (please circle)    YOUTH       or      ADULTS

This activity would take place (please circle) 

ONCE     or    MONTHLY    or     WEEKLY     or      OTHER

This activity will cost/the following will need to be paid for...

(Please use the back or another paper if needed.)







Return to or leave a hard copy at the office.


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