Enquire about our adult and community services To contact us about our adult and community services, please complete this form. Please fill out this form with your enquiry and we will get back to you shortly. Please make sure you fill in all the fields marked with an asterisk (*). Your details Title Mr Mrs Miss Ms Other First name * Last name * Telephone Email address * Address line 1 Address line 2 Address line 3 Postcode Country Local authority Your enquiry What does your enquiry relate to? Student support Employment support and services Vocational learning Accessing the community Leisure and social life Short breaks service Support in the home Residential services Family support Northern Ireland Autism Centre Volunteering * What is your enquiry? eg Do you want a list of vacancies, to give feedback, etc? Maximum of 512 characters allowed, including spaces. * Would you like us to email you a brochure? Yes No Other information How did you hear about us? NAS website Other website (please specify below) Search engine Email Direct Mail Your Autism Magazine Advertising (please specify below) Directory (please specify below) Word-of-mouth (please specify below) Other (please specify below) * Other (from drop-down above) How would you describe yourself? Person with autism Parent/carer of a child with autism Parent/carer of an adult with autism Family member of a person with autism Professional (please specify below) Social services representative (please specify below) Other (please specify below) Other (from drop-down above) Data protection The National Autistic Society would like to keep you informed about our services, upcoming news, events and fundraising activities. We will look after your data as set out in our privacy and data protection policy. If you prefer not to receive information by post, please tick this box If you prefer not to receive information by telephone, please tick this box We'd like to keep in touch by SMS on your mobile. If you are happy with this, please tick this box. We'd like to keep in touch by email. If you are happy with this, please tick this box.