YYJ Autism Aviation Day:Application Form

Primary Contact*

Please list the full name of the primary contact for this application. Enter name exactly as it appears on government issued ID.

Email*

*This email will be used for further communication regarding this event.

How many Autistic travelers are in your group?*

*The number of individuals/family members in this application who are on the autism spectrum.

Name of Autistic traveler 1*

Enter name exactly as it appears on government issued ID.

Name of Autistic traveler 2*

Enter name exactly as it appears on government issued ID.

Name of Autistic traveler 3*

Enter name exactly as it appears on government issued ID.

Name of Autistic traveler 4*

Enter name exactly as it appears on government issued ID.

Each Autistic traveler may be accompanied by 1-2 guests (primary contact, family members, caregivers, guardians, etc.), up to a total of 4 guests.

Number of guests*

How many guests are accompanying the Autistic traveler? Please include the primary contact if different from the Autistic traveler.

Number of guests for 2 or more Autistic travelers

How many guests will be accompanying the Autistic travelers? Please include the primary contact if different from the Autistic traveler.

Select

Guest 1

Enter name exactly as it appears on government issued ID.

Guest 2

Enter name exactly as it appears on government issued ID.

Guest 3

Enter name exactly as it appears on government issued ID.

Guest 4

Enter name exactly as it appears on government issued ID.

Does everyone above have government issued ID?*

It is required that each individual participating has a piece of government issued ID. Any individual who does not have government issued ID will be denied access by security.

Select

Accessibility Accommodations*

Do any guests listed in this application require accessibility accommodations for mobility, sight, hearing or other physical limitations?

(i.e. wheelchair access to plane, shuttle to gate, sign language interpretation, bringing a service dog, etc.)

Yes

Media Release Waiver*

Due to the nature of this event, media may be in attendance. If your group is confirmed for the tour, would you be willing to sign a media release waiver?

Yes

*As we cannot ensure those who do not wish to be videoed or photographed are protected from the media, individuals unable to sign a media release waiver will not be able to participate.

Why would you like to participate in this tour?*

Please be as descriptive as possible about why this tour would be meaningful for you or your family.

Support Needs?

Is there any additional information you would like to share about your support needs or the support needs of someone with whom you are applying? (Optional)

Would you be comfortable speaking to local media?*

There will be local media at this event. Would you or a family member be interested in speaking to media about your experience at the tour?

Yes

Are you a Canucks Autism Network member?*

CAN membership is NOT required to attend.

Yes

Would you like to receive CAN communications?

Stay up-to-date on Canucks Autism Network's upcoming programs, training and special events by signing up to our newsletter.

Yes

Thank you for your application for the YYJ Autism Aviation Day. Please note there are a limited number of spaces available. Due to the popularity of this event, we anticipate that we will not be able to accommodate everyone who wishes to attend.

Further details will be provided to those who receive confirmation of enrollment.

All applicants will be notified of their enrollment status by April 13, 2023.

Please ensure you click "Submit" to complete your application!

Personal Information

Application Questions