User Registration Form / Fiche d'Inscription de l'Utilisateur

General Information  * required  * required Which language do you prefer? French English  * required Enter your Address.	Which type of services would you like to have access to? Place to do Therapy Support Group "Outreach" Program Mini Workshops with Discussion Panel Conferences Family Activities Lending Library Parent Support Program Newsletter Teen Night Other Ideas or Comments...
Which means of communitcation do you prefer? Email Phone Mail Would you like to be informed of workshops, conferences or other activities organized by CAAFC? ---------------------------- Yes No How did you hear about us? Friend Link Web Search Newspaper Information Booth Mail TV Radio From a Professional Other...	---FOR PARENTS ONLY--- We want to know more about your child. Please fill in the following. Sex: ------------------------------ Male Female Diagnosis: ---------------------------- Autism Asperger Rett's Disorder PDD-NOS Childhood Disintegrative Disorder Other...
User Type ------------------------ Parent Extended Family (Siblings, grand parents, etc.) Health Professional School Professional Volunteer Friend Other Please specify your user type.	---FOR PARENTS ONLY--- Do you have any other children? If so, please add their names and ages.