ASP HOMEpowerment Application
The Autism Society Philippines is pleased to open the applications for Batch 8 of ASP's HOMEpowerment, a program that offers initial therapy to children with autism 8 years and below from indigent ASP member families. The program will be composed of occupational, speech and non-traditional therapy sessions. Parents will also receive training on how to continue their child's program at home, empowering them with the knowledge and skills to confidently care for their child with autism. This offering was made possible by the generous donation of Kiehl's Philippines, as part of a global effort to support autism causes.
Name of Parent Applicant *
LAST NAME / First Name of Parent Applicant
Your answer
Complete Street Address *
Your answer
Contact Email Address
Your answer
Contact Mobile Number *
Format: 9171234567
Your answer
Name of Child with Autism *
LAST NAME / First Name of Child with Autism
Your answer
Birthday of Child with Autism *
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.