*Disclaimer*: The information you are filling out is strictly confidential and information will be used for grant funding purposes only. All programs offered by the Autism Society of Colorado are usually free or at a discounted rate due to funding received by organizations and sponsorships.
 
You do not have to live in the state of Colorado to attend support groups. However, we do ask participants to live in the United States. If you need support groups in your state or country, please reach out to our Director of Programs at program@autismcolorado.org.
 
Once registration is filled out, participants will receive a Zoom notification that you've been registered for the Parents and Caregivers with Children (Under 18) group.
 
If you have any questions, comments, or concerns, please email program@autismcolorado.org.


ALL QUESTIONS BELOW RELATE TO THE INDIVIDUAL ATTENDING THE ONLINE GROUP AND MUST BE 18 YEARS OR OLDER.

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* 1. First Name: What is your first name?

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* 2. Last Name: What is your last name?

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* 3. Gender: How do you identify?

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* 4. Race/Ethnicity: Which race or ethnicity best describes you? (Please choose only one.)

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* 5. Age: What is your age group?

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* 6. Location: Are you currently in the state of Colorado?

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* 7. Location: What is your current city?

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* 8. Location: Please provide the zip code you live in? (5 digit zip code)

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* 9. I am or think I may be:

You are registering for the Parents and Caregivers with Children (Under 18) online peer support group. This group meets on the 1st and 3rd Tuesdays of each month from 7pm - 8pm MST.

Please provide a valid email address to be contacted for registration via Zoom, reminders, and updates on support groups. This is how you will be able to join via Zoom and receive updates.

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* 10. Email Address:

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* 11. By attending our online groups, you agree that you have read and acknowledged our ASC Online Peer Support Groups Policy.

ASC also has recommended guidelines as best practices for both ASC staff and participants when attending online groups.

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* 12. Do you wish to receive news or events about the Autism Society of Colorado community or support groups? (This is different from the newsletter)

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* 13. OPTIONAL: Is there anything you would like to share with the ASC facilitator that would help in support groups? (For example: anxiety, newly diagnosed, struggling socially, need resources, finding a community, etc.)

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* 14. OPTIONAL: What information or topic(s) do you want to discuss or interested in finding?

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* 15. INCENTIVE SURVEYS: Please select if you would like to participate in feedback and evaluation surveys for the Autism Society of Colorado's Support Groups. (Please note this is for grant data purposes only. Some surveys may have incentives depending on organization and funding that you'll receive via email)

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