 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
 |
|
Action for Autism Membership
Yes, I would like to Join AFA! AFA is a parent-directed organisation for which membership is open to persons with autism, parents, professionals, friends of autism anywhere in the world. It is a registered national society that networks with formal as well as nonformal groups. Membership entitles you to concessional rates at workshops and seminars, concessional library membership, issues of 'The Autism Network', free passes to events, and most importantly, with your membership, you provide support to Action for Autism and its activities. We welcome members from abroad as well as from within India. For membership from outside India, please contact AFA regarding the procedure.
Membership entitles you to concessional rates at workshops and seminars, concessional library membership, a free subscription to The Autism Network, free passes to events, and most importantly, with your membership, you provide support to Action for Autism and its activities. We do not require anyone to be an AFA member to make use of services and programmes, but we count on your continued support to help defray the ongoing costs of the organisation.
Please use this form if you have Adobe Acrobat, otherwise print and mail this page.
Name_____________________________
Address ___________________________
__________________________________
City_______________________________
State, Pin/Zip_______________________
Phone_____________________________
I am a: (tick all that apply)
___Parent Relative
___Professional (title:____________________)
___Other________________
If you are a parent of a person with autism, please answer:
Child's name______________________
Sex____ Date of birth (dd/mm/yr)________________
Diagnosis (if known)__________________________
Dues
Annual membership for Individuals Rs. 500/-
or upgrade to a Lifetime membership Rs. 5000/-
Annual membership for Professionals Rs. 1000/-
Annual membership for Institutions Rs. 2000/-
I wish to give a contribution to AFA. Amount: __________Mail cheque or bank draft payable to:
Action for Autism
click here for address
All contributions are tax exempt under Section 80 G of Income Tax Act.