AUTISM COMMUNITY NETWORK (ACN)
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Annual Member Survey 2016

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Dear Member,
The ACN is committed to improving the services we offer to people with ASD and their families. This is why we ask that you take time out from your busy day to complete our annual member survey. The survey will help us understand the challenges that you face as well as the barriers and supports currently available to you.

We also want to find out what you think of the services that ACN currently offers and your preferred days/times for services to be made available. We are also very interested in any ideas that you might have for additional services and resources that we could provide.

The survey is anonymous and is designed to give us general information only. Please see our Privacy Policy for more details.

We will use the information to plan our services and may provide de-identified statistics to communicate to government and philanthropic organisations. On our own, bureaucracies can seem overwhelming but together, 900+ families have a real voice and can make a significant difference.

On behalf of the ACN Board, I would like to thank you all in advance for your support in completing this survey.

Best wishes,

Warren Thompson
President


    Section 1: Adult with ASD or Primary Carer

    This section asks about you so that we can get a better understanding of your needs. 
    Your preferred times
    We offer a range of programs at during school terms/school holidays, weekdays/weekends, days/afternoons/evenings. This next section allows you to identify the times that suit your family best for the activities in which you have an interest.

    Section 2: Your household

    Please complete the table for anyone else in your family or household who would like to use ACN services. This includes children and adults with ASD, partners, parents, carers and siblings of people with ASD.

    Section 3: About the Autism Community Network (ACN)

    Existing Autism Community Network (ACN) services
    Let us know what you think of any ACN services that you have used over the past 12
    months. 














    Possible new programs 
    Let us know what programs you are currently attending elsewhere and what you would like the Autism Community Network to provide.
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    Your email will only be used for the running of the draw. Your survey responses will be de-identified.
    Thanks again for completing this survey. It will help us to plan for the future and to get funding to provide more services.
Submit
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Phone: 02 9543 9036
Email: info@autismcommunity.org.au 
Street Address: Illawong Community Centre 
-1F, 273 Fowler Road Illawong NSW 2234 
Postal Address: PO Box 188, Riverwood NSW 2210
ABN 64 103 662 535
INC 9896017
CFN/22825