SCHOLARSHIP APPLICATION

Name: Adult Neurodiverse Connections Group (18+)
Start: 2025-02-22T13:00:00-08:00
End: 2025-02-22T15:00:00-08:00
Location: Insert Coin

We are happy that you have chosen to apply for a full or partial scholarship to attend our event!

We feel that no barrier should come between sharing the important information and experience that is this important information.

Please answer the following questions. Shortly following your submission, the Lewis County Autism Coalition will reach out to you

to discuss next steps.

Can't wait to meet you!

First name

Last name

Street Address (or) P.O. Box

City, State

Zip Code

Phone

Yes, subscribe me to your newsletter.

What is the name of the event you seek a scholarship for?

INTEREST IN THE EVENT: Why are you interested in participating? Please share about your family, your child's age(s), needs (Diagnosis if any, behaviors, challenges, concerns), or anything else you feel is important for us to know.

FINANCIAL NEED: Please describe your financial need for this scholarship?(Please limit your response to 150 words.)

Are you requesting a FULL or PARTIAL Scholarship? If you are able to contribute any portion of the admission cost, please include the dollar amount below.

Do you require any special accommodations (i.e., translator, seating, other) If no, write N/A. If yes, please describe.

Adult Neurodiverse Connections Group (18+)

Sat, Feb 22

Insert Coin

Ready to level up your social connections? Join us for an exciting evening of retro and modern arcade fun at Insert Coin!

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Adult Neurodiverse Connections Group (18+)

Time & Location

Feb 22, 2025, 1:00 PM – 3:00 PM

Insert Coin, 309 N Tower Ave, Centralia, WA 98531, USA

About the Event

We’ll meet at Insert Coin for gaming and camaraderie. We had so much fun the last time we visited here and can't wait to do it again! From classic arcade games to the latest hits, there’s something for everyone. Don’t miss out on the chance to connect and have fun in this vibrant atmosphere!

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SCHOLARSHIP APPLICATION

Adult Neurodiverse Connections Group (18+)

Time & Location

About the Event

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