2019/20 Autism Intervention Trust Financial Membership Form

Thanks for joining or renewing your Autism Intervention Trust Financial membership. Our membership year runs from 1 April 2019 to 31 March 2020 but you can join at any time.

Financial membership gives preferential booking and discounted prices for events and activities that incur a fee. Membership costs $69 per year.

Only want emails from Autism Intervention Trust? Signup here: http://www.autisminterventiontrust.org.nz/?page_id=1138

This form will take approximately 5 minutes to complete

Are you a new member or are you renewing your membership? *

Name(s) of adults in this membership: *

Your answer

Main email address *

Your answer

Alternative email address

For second person or alternative email

Your answer

Please tell us about your main interest in autism *

This helps us to know our members and better plan our activities.

Parent(s) or Guardian(s) of a child with autism

I am on the autism spectrum

Friend or relative of someone with autism

I work with or care for children with autism

I'm an education or health professional

I'm a student learning or researching in the field of autism

I'm a volunteer who wants to help the Trust

Other:

What information and activities are you interested in?

School holiday programme

ASD gym class

Information about Early-Intervention Therapy

Other:

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