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Register your interest below in becoming a Gold Foundation member. By doing so, you will gain access to our programs and receive general communications from us about our services.

Child's First Name*
Child's Last Name*
Child's Date of Birth*
DD slash MM slash YYYY
Age*
Gender*
Parent's/Caregiver's Name*
Address*
Street Address Address Line 2 City State Post Code Country
Email*
Contact Number 1*
Contact number 2 (optional)
Diagnosis
Year of Diagnosis
Where did you hear about The Gold Foundation?
What are your main concerns in regards for your child
For example: social, educational, behavioural
Any family background or other relevant information
eg: relationship between family members, medical issues
Which of the following would you/your child be interested in
- Cadets
- What’s The Buzz
- Discovery Program for Girls
- Youth Group
- Not So Youth Group
- Events & Seminars
- Cooking Connection
Do you give consent for Gold Foundation to take photos of your child for advertising purposes?
- Yes
- No
Would you like to receive a phone call to discuss participation in a program?*
- Yes
- No

Donate today to support the work of Gold Foundation. Your donation will help young people with Asperger’s to discover their unique abilities.

Make a Donation

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- Youth Group (ages 13-18)

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