Contact Mid-Michigan Autism Association

Please complete the fields below and click Submit.
We will try to respond within 24 hours. Thank You!
(* Fields are required)

*First Name:
*Last Name:
*Primary Role:
Secondary Role:
If you are a Parent, please tell us a little about your child:

Male
Female  
14 or younger
15 - 26
27 or older  
Diagnosis:
School District:
Daytime Phone:
Evening Phone:
*Email:
Comments:
Would you like to be added to MMAA's email list to receive periodic updates and event notifications?
  Yes, sign me up!
  No, thank you.  
Include me in other Autism organization's mailings! ex. Michigan Autism Insurance Reform Coalition Newsletter
  Yes, sign me up!
  No, thank you.  

Mid-Michigan Autism Association
PO Box 27462
Lansing, Michigan 48909
info@midmichiganautism.org

Webmaster Ann Green

Content copyright 2009-2010. Mid-Michigan Autism Association. All rights reserved.