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Application for 'Start a Social Club'
Please use this form to apply for the Licensing and/or Coaching Program.
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* Indicates required question
Email
*
Your email
Name
*
Your answer
Current Role (check all that apply)
*
Teacher
Therapist
Parent
Other
Required
Which program are you applying for?
*
Choose
Licensing Program
Coaching Program
Both
Why are you applying to this program?
*
Your answer
Please describe your personal and/or professional experience with autistic and ADHD kids.
*
Your answer
Anything else you would like to add?
Your answer
You will receive an email with the link to schedule your appointment with me upon receiving your application. I look forward to meeting you! - Steph
A copy of your responses will be emailed to the address you provided.
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