ASK Champion - About Special Kids

First Name*:

Last Name*:

Street Address*:

City*:

State:

IN

Zip Code*

County*:

Home Phone*:

Other Phone:

Email*:

Language(s) spoken other than English:

For reporting purposes we are required to obtain the following information:

Race:*

Please indicate your level of knowledge about ASK and what ASK does for families:

I have worked with a parent liaison or other staff member and understand what ASK does
I need more information

Please check what you are interested in learning more about:

Distribute ASK collateral materials to organizations/professionals that serve kids with special needs
Man tables at resource fairs for ASK
Make presentations to organizations and groups that serve kids with special needs
Interviewing families and writing family stories
Volunteering at the office (filing/copying)
Parent Mentoring. A Parent Mentor is a trained volunteer parent of a child with special needs, who is willing to give peer support to another parent (if you check here, you will be directed immediately to the Parent Mentor online training)

I am available:

Weekdays
Weekends
Evenings