Social Group for Autistic Teens
xMinds is hoping to organize some social activities for our autistic teenagers in Montgomery County. We've put together this survey to learn more about what your kids are interested in doing and if they have any specific needs or accommodations to make it an inclusive activity.
Sign in to Google to save your progress. Learn more
Email *
How old is your child?
*
What grade is your child in?
*
Where does your child attend school?
 *
Would your child be interested in meeting in person or virtually?
*
What are your child's special interests? (Feel free to provide specific details)
Would your child be interested in the following virtual activities? Please check all that apply.
Would your child be interested in the following in person activities? Please check all that apply. (Elaborate and give details in the following question)
Please provide specific details related to above question, if appropriate.
Please provide other ideas / activities in which your child would be interested (either virtually or in person).
Does your child have any motor challenges or sensory issues that may prevent them from participating in activities? If yes, please elaborate.
Does your child require one-to-one supervision in community settings? (Adult supervision will be provided, but we specifically want to know if your child may be prone to eloping)
 *
Please provide us with any additional ideas or information you'd like to share with us.
Would you like to help plan or host any of these activities? 
Parent's/Guardian's First and Last Name
 *
Parent's/Guardian's Mobile Phone Number
 *
Parent's/Guardian's Email Address
 *
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Partnership for Extraordinary Minds. Report Abuse
Google Forms