Collaboration Request Form

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This form should be used to submit a training request, or any other collaboration from Autism Alliance of Michigan Staff with your organization. A response will be sent to the below email address within 1 week. If you have any additional questions, please do not hesitate to email trainings@aaomi.org

Email *

Which of the following are you requesting: *

Overview Presentation of AAoM programs

Autism 101 Training - In person or virtual

Custom training material or organizational partnership

Request for conference speaker or panelist

Sensory consultation (assessment and recommendation of environmental adaptations)

Vendor/ Booth Appearance

Letter of Support/ Endorsement

Other

Required

Name and Title *

Phone Number *

Please specify date of event *

Event Title and Time *

Event Location (In- Person Address OR Virtual) *

How many participants do you anticipate will attend this event? *

Have you previously collaborated with the Autism Alliance of Michigan?

Yes

Clear selection

Please include a description of the program and details around the supports you are requesting from Autism Alliance of Michigan. *

Send me a copy of my responses.

Submit

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This form was created inside of Autism Alliance of Michigan.