AUTISM COMMUNITY NETWORK (ACN)
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Dream Night at the Zoo 2017 - Thu 7 December at Taronga Zoo
Members' Application Form
Once again, the ACN has been provided with a limited amount of tickets to the Dream Night at the Zoo event. As per ACN policy, priority will be given to volunteers involved in helping us provide our support programs and run the organisation, followed by people who regularly attend groups and events. To apply for a family pass for 4, please provide information below . Note: This offer is only available to carers registered with the Autism Community Network prior to 6 November 2017.
Every section must be completed to be considered
Indicates required field
Your ACN Member Name
You must be registered with ACN prior to 6 Nov '17 to apply
Child with ASD
Age of Child
Contact Telephone No.
Postal Address - Street
Which ACN group or activity do you attend ?
How many ticket entries required?
Each pass is for the child plus 3 guests. If you have more than 4 people in your family please let us know and we will try to accommodate your need if possible.
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Phone: 02 9543 9036
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