Spectrum Connection

What Does it Offer
Register

*Integrated Autism Consulting is available to support and facilitate but all individuals must be able to attend the event independently.

How to Register

Please complete an on-line intake form.
The facilitator will connect with you.
You will receive an email confirmation and a request for payment before the first day of the month.
Please pay by e-transfer or on the website under Pay On-line. Receipts will be issued.
Payment is due, for returning participants, on or before the first day of each month.

Please fill out this form to Register for Spectrum Connection

Date of Birth*
MM slash DD slash YYYY
Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email*
Emergency Contact*
Please provide any additional information that we should know about you.
Would you like to receive our newsletter by email?*
- Yes
- No

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