Application For Activity Funding

We want our friends, who are diagnosed with an autism spectrum disorder (ASD) to be out in our North San Diego County Community, having fun in social activities!

Please complete the form below

Name of Participant *
Name of Participant
Phone
Phone
Home Address
Home Address
Must live in North San Diego County, CA
What social activity would the participant like to try, for 4 weeks? *
(Choose one)