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Autism & Special Needs Registry

  1. Introduction

    Please complete and submit this form if you have a loved one with autism and/or special needs who lives in the city of Warrensburg or spends a significant amount of time in Warrensburg. Note: we recommend re-submitting this form with updated information on an annual basis. Information that has been on file for more than a year will periodically be purged.

  2. Instructions

    Complete the fields below as they pertain to the person with autism and/or special needs.

  3. Instructions

    Complete the fields below as they pertain to the person completing this form.

  4. Instructions

    Complete the fields below as they pertain to a secondary emergency contact (if applicable).

  5. Leave This Blank:

  6. This field is not part of the form submission.