Registration Form


Numbers are powerful tools to take to the Ministry of Community and Social Services in order to effectively advocate for change.

If more supports, services and understanding for adults with Autism and adults with Aspergers are important issues to you, add YOUR VOICE through COUNT ME IN.

I'd like to be counted as an Ontarian that wants to speak out for more support, services and understanding for adults with Autism and adults with Aspergers!


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? 
I would like to receive occasional email newsletters from Autism Ontario
about news and information for adults with Autism and Aspergers
Yes
I would like to receive occasional printed newsletters from Autism Ontario about news and information
for adults with Autism and Aspergers (your mailing address is required).
Yes

You can either complete this form online or by printing and submitting it by:
fax: 416-246-9417 or mail:
Autism Ontario, 1179A King Street West, Suite 004 Toronto ON M6K 3C5.











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