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Registration Form

Title 
First Name 
Last Name
Street Address
Address (cont)
City
Province
Postal Code
Contact Number
Email
Are you an Autism Ontario Member? Yes
Are you an Adult with Autism? Yes
Are you an Adult with Aspergers? Yes
Are you a parent of an Adult with Autism? Yes
Are you a parent of an Adult with Aspergers? Yes
Do you have a sibling with Autism or Aspergers? Yes
Year of Birth
Would you like to be kept up to date on matters relating to adults with Autism or Aspergers? Yes
Any other comments for us? 




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