Scottish Autism Service Network

Scottish Autism Service Network
Membership Form

Please fill in your full name and the information that has changed, if you are here by accident and want to join the SASN click here instead.

Please tick which of the boxes below apply:

I give permission for my name to be included on a mailing list to receive the following: copies of the SASN newsletter, information regarding ASD research, resources, events, training and services across Scotland and information regarding local autism networks and how to participate

I give permission for details of my organisation/service to be included in a database of services and resources for ASD to be disseminated to professionals, parents and people with ASD as appropriate

I give permission for my details to be passed on to carefully selected similar organisations, services and professionals for the purpose of my receiving further information about ASD*

I give permission for the Scottish Autism Service Network to refer queries to my service/organisation

Title:
Mr Mrs Ms Miss Other    Please state other

Name:

Job Title (if applicable):

Name of organisation/service (if applicable):

Nature of organisation/service (if applicable):

Address:

Postcode/Zip Code:

Telephone Number:

Email:

I am (please tick one)...
a person with an ASD
a partner of someone with ASD
a carer of someone with ASD
a parent of a someone with ASD
a practitioner working in the field of ASD