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What is Autism
Resource Directory
AuSM Celebrates Interdependence
Social Narratives
Voting Resources
Scholarships and Waivers
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COVID-19 Resources
AuSM Shop
Information and Resources
Therapy
Meet Our Therapists
Ask the Therapist
Support Groups
Make an Appointment
ACCS Publications
Events
State Autism Conference
Steps for Autism in Minnesota
Puzzle Competition
Give to the Max Day
Autistic Community Summit
Autism Acceptance Month
Ignite Inclusion
Education
Social and Recreation Programs
AuSM Skillshops
Adult Coffee Club
Classes
Training
Workshops
Practical and Innovative Strategies For Teaching Academic and Life Skills
AuSM Celebrates Interdependence
Camps
Hand in Hand
Discovery
Day Camp
Camp Questions and Answers
Work at Camp
Get Involved
Volunteer
Fundraise for AuSM
Reach the Community
Policy Advocacy
Become a Presenter
Research Studies
Get Involved
Policy Advocacy
Advocacy Committee Interest Form
Advocacy Committee Interest Form
Thank you for your interest in the AuSM Advocacy Committee. Please tell us about yourself by completing the below information. Once you submit the completed form, the AuSM Advocacy Committee co-chairs will contact you.
Name
*
First
Last
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
E-mail
*
Phone
*
Legislative District
What is your relationship to the autism community
Person with autism/autistic
Parent
Family member
Professional
Educator
Other
If other, please specify
Please indicate your area(s) of interest. Check all that apply.
Education
Transition
Early intervention
Improved quality of services
First responder training
Employment
Housing
Human services (waivers, PCA, etc.)
Transportation
Autism specific legislation
Other
If other, please specify.
What is your availability for in-person meetings or phone calls? Check all that apply.
Weekday mornings
Weekday afternoons
Weekday evenings
Weekends
Are you interested in joining the AuSM Advocacy Committee Facebook group?
Yes
No
I would like more information
What level of commitment are you interested in making to the AuSM Advocacy Committee?
I would like to be involved in planning and contacting legislators.
I am interested in working with the group to get my voice and concerns heard.
I will contact representatives as needed from my home.
I want to stay in the loop on the issues, but do not have a lot of time to spend organizing.
I want to help with research and organizing, but I don't want to talk to people.
I am not sure yet.
Do you have any previous advocacy experience? Check all that apply.
I have met with my senators and/or representatives at the Capitol.
I have written or called lawmakers about issues important to me.
I have attended marches or rallies for issues important to me.
I have completed advocacy training through another organization.
I am a Partners in Policymaking graduate.
Other
If other, please explain.
Do you have any other comments, questions or concerns about the AuSM Advocacy Committee?
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