Hussman Center for Adults with Autism Program Interest Indication Form

Hussman Center for Adults with Autism Program Interest Indication Form

First Name:

Last Name:

Email:

Programs will begin the Week of June 30th and End the Week of August 4th (unless otherwise noted on our program calendar which is found on our website).

How many programs would you like to participate in this semester?

123

Top Program Choice:

Act with MaxArt ClubBaking with Dr. BurgerCo-Ed ActivitiesCooking 101CraftsmanshipGarden ClubGamingHealthy RelationshipsMulti-Modal ConversationsScrapbooking & CardmakingTriviaWork Possibilities

Second Program Choice:

Act with MaxArt ClubBaking with Dr. BurgerCo-Ed ActivitiesCooking 101CraftsmanshipGarden ClubGamingHealthy RelationshipsMulti-Modal ConversationsScrapbooking & CardmakingTriviaWork Possibilities

Third Program Choice:

Act with MaxArt ClubBaking with Dr. BurgerCo-Ed ActivitiesCooking 101CraftsmanshipGarden ClubGamingHealthy RelationshipsMulti-Modal ConversationsScrapbooking & CardmakingTriviaWork Possibilities

Selecting a program indicates that you are interested in attending that program.

Selecting a program does not guarantee program acceptance. You will be notified if there is space in the programs for you to attend.

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Contact Information