|
GRASP Membership and Intake
|
| Title: |
|
| First Name*: |
|
| Last Name*: |
|
| E-mail address*: |
|
| Company/Organization: |
|
| Address 1*: |
|
| Address 2: |
|
| City*: |
|
| State*: |
|
| Zip/Postal Code*: |
|
| Country*: |
|
| Telephone*: |
|
| What is your relationship to the Autistic Community?*: |
|
| Where did you learn about GRASP?: |
Internet
Friend/Relative
Online
Social
Advertisement
Unsure/Don't
|
| Please READ this section CAREFULLY as all GRASP and non-GRASP members are expected to follow these rules when engaging in GRASP’s programs and services. 1.) Treat other members and facilitators with respect and dignity. 2.) Unless someone asks for feedback, refrain from commenting about or asking them unwelcome questions, especially in regard to their appearance, hygiene, dating life, etc. 3.) No language or comments that targets a person or a specific group of people, present or not present at the meeting, will be tolerated. 4.) Members must be fully clothed to participate in online chat or support group events. 5.) These groups are a safe space and any information shared in the meetings is confidential, including member names. 6.) A GRASP facilitator's direction or decision is final. If you do not agree with it, then please leave the chat or group and email your concern to a GRASP administrator. 7.) Rules will be enforced with reminders and warnings. If you are unable to follow these rules after reminders and warnings, you may be suspended for a minimum of 30 days. If after suspension and warnings you continue to not follow these rules, you may be permanently banned. If your behavior is seriously unsafe or violent, then you may be banned without warning. 8.) We reserve the right to collect and provide law enforcement with your personal information and relevant chat information if you violate these rules in a way that indicates significant property damage, puts another person, or yourself at risk of serious injury.*: |
Agree
|
| In consideration of participation in the programs, activities, and services provided by Global and Regional Autism Spectrum Partnership (known as “GRASP”), I agree to release GRASP and its trustees, officers, employees, agents and volunteers from any and all liabilities, damages, losses and/or causes of action (collectively, "Claims") that I may suffer or have, including without limitation, to our persons or property or both, which arise out of, are related to or in connection with, or occur during, participation in or attendance at the programs, activities, or services. I further agree to indemnify and hold harmless GRASP and its trustees, officers, employees, and volunteers from any and all Claims arising out of, related to, or in connection with the programs, activities, and services that are caused by my negligent or intentional acts and/or omissions.*: |
Agree
|
|
Become a Patron by copying and pasting this link:
https://www.patreon.com/grasp_org?fan_landing=true:
|
|
| Are you interested in a GRASP Assessment? If yes, we will send you a follow-up email: |
Yes
|
| Are you interested in GRASP Coaching? If yes, we will send you a follow-up email: |
Yes
|
| Are you interested in any other GRASP Program or Service?: |
|
| Are you interested in community-based services? Please type the services you are looking for: |
|
|
What is your insurance? (For those who are looking for community-based services where applicable):
|
|
|
GRASP Groups:
|
| GRASP Global Network: |
|
| Mondays weekly Zoom chat group: |
|
| Women & Non-Binary 1st and 3rd Mondays: |
|
| LGBTQIA+ Community : |
|
| Men's Group: |
|
| Neurotypical Parents, Caregivers, and Families : |
|
| Autistic Parents, Step-parents, and Caregivers: |
|
| Over 50's Group: |
|
| GRASP en Español: |
|
| Black, Brown, Indigenous, and Melanated People : |
|
| Neurotypical Partners/Significant Others : |
|
| Clinicians and Therapists : |
|
| Teachers, Para-professionals, and aides : |
|
|
Faith-Based Support Group:
|
|
|
Subscribe Unsubscribe
|
| |
