Personal Details Your Child’s Details Membership Options Payment Twitter Prefix Mrs. Ms. Mr. Dr. First Name * Last Name * Email * Phone Number Street Address Supplemental Address City Postcode County Select a State/Province Country Select a CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryVirgin Islands, BritishBrunei DarussalamBulgariaBurkina FasoMyanmarBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo, The Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d’IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicTimor-LesteEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly See (Vatican City State)HondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic OfIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoNorth MacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States ofMoldovaMonacoMongoliaMontserratMoroccoMozambiqueNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaReunionSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSaudi ArabiaSenegalSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSpainSri LankaSudanSurinameSvalbard and Jan MayenEswatiniSwedenSwitzerlandSyrian Arab RepublicSao Tome and PrincipeTaiwanTajikistanTanzania, United Republic ofThailandBahamasGambiaTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States Minor Outlying IslandsUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenSerbia and MontenegroZambiaZimbabweÅland IslandsSerbiaMontenegroJerseyGuernseyIsle of ManSouth SudanCuraçaoSint Maarten (Dutch Part)Bonaire, Saint Eustatius and SabaKosovoSaint BarthélemySaint Martin (French part) Name of Child: First Name Last Name Date of Birth Type of School MainStream Special School N/A Home Educated Above School Age Below School Age Name of School Gender Female Male Other Ethnicity Asian Black Mixed Race White Other Does the child have a formal diagnosis of autism? Yes No Does the child have an EHCP? Yes No Would you like to add another child? Yes No For Renewals only Do you feel your child(ren) has/ve: * Improved their social skills Made new friends Become more independent and confident Been able to access a range of new experiences and opportunities Made progress in developing appropriate play skills Had fun! Not applicable As parent carers, do you feel that AWARE has: * Helped you gain more information about autism Helped you become more confident Made you feel less isolated Given you opportunities to meet other parent carers Provided opportunities for shared emotional support Signposted you to relevant other sources of advice and information to better support your child and family Not applicable Please give examples of how membership of AWARE has helped your child(ren) and your family so that we can learn from good practice. Where did you hear about us? Word of mouth Internet search Leaflet Other (please state) Paediatrician CAMHS School Other AWARE member Family Membership * Family Membership – £15 Optional Donation * It is much more beneficial for AWARE and simpler for you if you pay by BACS (direct bank transfer) or cheque, otherwise some of the cost will go to covering payment processing costs. However, we understand card payments are the only option for some, so this is also available. Do you want to pay by Bank Transfer or Cheque? Yes Amount Total: £ AWARE are committed to meeting all relevant obligations relating to this website that apply under the Data Protection Act of 1998 and the General Data Protection Regulations 2018. We will strive to observe the law in all collection and processing of subject data and will meet any subject access request in compliance with the law. We will only use data in ways relevant to carrying out its legitimate purposes and functions in a way that is not prejudicial to the interests of individuals. We will take due care in the collection and storage of any sensitive data. We will do our utmost to keep all data accurate, timely and secure.