Video Streaming Library Low-Income Scholarship Application
Want access to world-class resources, including the US Autism Association’s Video Streaming Library, but need help paying? The US Autism Association is proud to offer financial assistance so a limited number of individuals, or family members of individuals affected by autism can register for no charge.  Please complete the application, and we'll be in contact!

Questions? Contact us by sending an email to support@usautism.org.

The Video Streaming Library is intended to provide professionally curated, high-quality online resources to those who visit. Scholarship recipients will have access to the Video Streaming Library for twelve months, during which they can view videos on-demand, and even with their family or friends (if they so desire).

Sign in to Google to save your progress. Learn more
Who is the ideal scholarship recipient?
There are only two requirements for scholarship recipients:
1. You must be an individual or family member of an individual affected by autism.
2. To receive an Autism Speaks-supported scholarship, you must be a resident (or member of a community in) Connecticut. (If you don't fulfill this requirement, please fill out this application anyway, and we may be able to accept your application through other scholarship partners.)
Are you a non-vocal individual or a family member of a non-vocal individual? *
Disclaimer

The US Autism Association reserves the right to ask for more documentation of income or other documentation. We reserve the right to make final decisions at any time, whether based on income, limiting or changing the number of scholarships available, or eliminating scholarship registrations altogether. By submitting this application, I am electronically signing this application. I agree that all statements made on this application are true and that any further information provided to US Autism Association for the purpose of receiving this scholarship are accurate and true. 

Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of US Autism Association. Report Abuse
Google Forms