What is your child’s name, age and diagnosis.(Required)When were they diagnosed with autism? Are they verbal or non-verbal?(Required)Does your child use a speech generating device?(Required)Who recommended you receive toys/equipment? (OT, PT, Teacher?)(Required)What types of sensory equipment can your child benefit from?(Required)What is the approximate cost of items your child would use the scholarship money for?(Required)Where does your child attend school?(Required)Do they receive any additional services?(Required)Does your child have any behavioral difficulties?(Required)Your Name First Last Your Email CAPTCHA
