2020 Symposium Fee Waiver Application
Thank you for your interest in the 4th Annual Southeast Adult Autism Symposium. The Symposium will be held virtually on Friday, July 24 and Saturday, July 25.

Registration waivers are made possible from scholarships from Tennessee Council on Developmental Disabilities and the Georgia Council on Developmental Disabilities. These waivers are meant to support individuals experiencing economic distress and cannot afford to pay the registration fee.

These organizations require us to collect demographic information for waiver recipients and we are required to have recipients fill out a satisfaction survey after the symposium. We have added the demographic questions to this form.

We will contact you after completing this form to confirm you are receiving a waiver and will register you for the symposium.
First Name
Enter first name of individual seeking waiver
Last name
Street Address
City
State
Phone
(xxx) xxx-xxxx format
Email
Identity
Select the option(s) that fit for person seeking waiver. I am a(an)....
Area
What is the geographical area around where you live?
Clear selection
Gender
How would you describe your gender?
Clear selection
Ethnicity
What is your race/culture/ethnicity? Please choose what best fits you.
Clear selection
Survey
I will complete a satisfaction survey after I attend the symposium.
Clear selection
Submit
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