Autism & Neurodiversity Concession Form - Positive Psychology Network

First Name(Required)

Last Name(Required)

Phone(Required)

Email(Required)

Address(Required)

Nationality

Gender

Male

Female

Other

Age

18-25 years

26-35 years

36-50 years

51+ years

1. Which course are you applying for? (please note you may only select one option)(Required)

Level 3 Certificate (Train-the-Trainer) Neurodiversity & Inclusion

Level 5 Diploma Autism Research, Theory & Practice for Managers & Practitioners

2. Which qualifications or certifications do you currently hold?(Required)

(Please attach copies to your application)

3a. Have you previously studied Neurodiversity & Inclusion?(Required)

Yes

No

3b. Have you previously studied Strengths-Based Approaches to Autism?(Required)

Yes

No

3. Details

Please provide details below:

1. What is your current role or focus in life and/or work?(Required)

2. Do you have any learning differences we should be aware of?

If you do, please mention these below. For example, oral presentations in place of written assignments or a slower learning pace.

2. How do you hope to use your course certification after graduation?(Required)

Please describe below how you will apply your course learning to make a difference in your community, workplace, or family.

Concession – Autism & Neurodiversity Course Application Form