Society Membership Application

APPLICATION FOR SOCIETY MEMBERSHIP

To: AUTISM SOCIETY OF BRITISH COLUMBIA (Doing Business As: AutismBC)

And To: The Directors of the Society

First Name *

Last Name *

Email *

City *

Province *

Membership Group *

Indigenous, Black, People of Colour (IBPOC)

Autistic Adult

Other

Other Family Member

Other Professional

Parent of Autistic Child

Parent of an Autistic Adult

Professional in the Field

Student

What is your primary reason for wishing to become a Society Member? *

Please describe how you became interested in AutismBC’s mission? *

Do you have a personal connection to autism and/or the goals of AutismBC? *

How have you been involved with AutismBC and/or the autism community in the past? *

What direction would you like to see AutismBC going in the future? *

Please explain the attributes, skills and qualifications that you can offer as a Society Member. *

I Confirm *

Name / Signature: