Registration

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

Child's First Name*
Child's Last Name*
Child's Date of Birth*
Date Format: DD slash MM slash YYYY
Age*
Gender*
Parent's/Caregiver's Name*
Address*
Street Address Address Line 2 City State Post Code Country
Email*
Phone
Mobile
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
Please describe any relevant family background information
eg: relationship between family members, medical issues
Other information
For example: likes/dislikes, other diagnosis
Which of the following would you/your child be interested in
- Cadets
- What’s The Buzz
- You Can Do It
- 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

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

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