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Neurodiversity Connections Questionnaire
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Email
*
Your email
Today's Date:
Your answer
Name: First and Last
*
Your answer
Hometown/State/Country
Your answer
Are you interested in participating in the weekly
Neurodiversity Connections drop-ins
on Thursdays from 3 to 4pm?
Yes
No
Maybe
Other:
Clear selection
If so, do you have topics of interest you'd like to discuss at our weekly
Neurodiversity Connections drop-ins
?
Your answer
Would you like to participate in a
student-led
Neurodiversity Social Club
on campus through Student Leadership and Engagement?
*
Yes, I'd like to participate
Yes, I'd like to be a leader
No, I'm not interested in participating
Other:
If you are interested in participating in the
student-led
Neurodiversity Social Club
, what days and times are you available for activities?
Your answer
What are some ways you'd like to connect with other students? (Check all that apply)
*
Board or card games
Video games
Sports
Movies / movie night?
Walks / hikes
Coffee/Food outings
Other:
Required
If you answered "other" in the section above, please provide your suggestion(s).
Your answer
Where are some of your favorite places to hang out away from campus?
Your answer
Where are some of your favorite places to hang out on campus?
*
Your answer
Is there anything else you'd like to share about yourself and/or your interest in neurodiversity?
Your answer
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