Autism in Cricket - Link Up with Us! - Autism Association of Western Australia

Your details

Your name*

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Email*

Phone*

I am a..*

Please specify 'other'*

Suburb*

Which cricket program are in you interested in?*

Email Newsletter Signup

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Details of the person wanting to play cricket.

Name*

First Last

Age:*

Preferred suburb/area to play cricket in:*

Is the participant currently accessing therapy supports with the Autism Association of WA?*

If yes, who is your current therapist?

If no, do you currently receive any therapy support?*

Do you have a support worker?*

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If relevant, which of the following options best describes the participants schooling supports?

Phone

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