What is the best way to contact you? Please select all that apply. * Do you live in the 7-county Twin Cities metro area (Anoka, Carver, Dakota, Hennepin, Ramsey, Scott, or Washington County)? *
Due to our limited resources, we can only allow Minnesota residents who live in the listed seven counties.
City, State, ZIP * Do you have proof of an official autism diagnosis? *
For the purposes of our research study with the University of Minnesota, we require proof of an official autism diagnosis as a criterion to participate in AMP this year. We hope to expand to include self-diagnosis in the future.
Do you have a guardian? *
If you have a guardian, please fill out the guardian-related fields below. If you do not have a guardian, please skip to the question "Why do you want to be an AMP mentor?"
Guardian Email Guardian Phone # What are your guardian's preferred methods of contact? Why do you want to be an AMP mentor? * What strengths/skills/experiences could you offer as a mentor to an autistic teen? Please explain. * Are you able to commit to meeting with a mentee via Zoom for 1 to 1-1/2 hours/week during the upcoming school year? * Please list your availability on weekday afternoons/evenings and weekends for a weekly 90-minute Zoom call during the school year. If you don't know, please indicate when you will have a finalized schedule. * Can you commit to participating for a minimum of one school year? * What questions do you have about the program? *
If you have questions after completing this form, you can email firstname.lastname@example.org.
By typing my name below, I grant permission for AMP to contact me online to conduct a personal interview for additional screening and for ongoing participation in the mentorship program. * Where did you hear about AMP?