Access Austin Demographic Information Form
The Autism Society of Texas is funded through private donations and grants.  Thanks to a grant from the City of Austin, we are able to provide this social group free of cost to the participating adults.  In order to be in compliance with the grant requirements, we need to collect the following demographic information to report back to the city.  Your name and more specific identifying information will not be included in the report.  Thank you for participating so that we can keep this program going!
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Please provide your full name. This information will remain confidential. We only report the raw demographic data to the city. *
Do you make less than $2,100 per month (or $25,200 per year)? *
Required
Gender *
Required
Race *
Required
Ethnicity *
Required
Age *
Required
Zip Code *
Address
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