Become a Member

Joining is free! Parents, family members, legal guardians and caretakers of children on the autism spectrum have full access to free services, programs, family enrichment activities and resources available through D.A.T.S.M.O.M.

If you are providing an e-mail address, please be sure to check your e-mail for submission confirmation. If this is your first time contacting D.A.T.S.M.O.M., please check your spam folder. If you have not received a confirmation e-mail within 7 days of your online submission, please call 334-659-6013. Thank you.
Name
First Last
Address
Street Address City State ZIP Code
Age
Race
Marital Status (M for Married or S for Single)
County You Reside In
Phone Number
Cell Number
Email Address
Facebook Profile (if different from name above)
(1) Child's Name with Autism
Age
Date of Birth
MM slash DD slash YYYY
Gender of Child
Age of child when diagnosed with Autism Spectrum Disorder
(2) Child's Name with Autism
Age
Date of Birth
MM slash DD slash YYYY
Gender of Child
Age of child when diagnosed with Autism Spectrum Disorder
(3) Child's Name with Autism
Age
Date of Birth
MM slash DD slash YYYY
Gender of Child
Age of child when diagnosed with Autism Spectrum Disorder
(4) Child's Name with Autism
Age
Date of Birth
MM slash DD slash YYYY
Gender of Child
Age of child when diagnosed with Autism Spectrum Disorder
(5) Child's Name with Autism
Age
Date of Birth
MM slash DD slash YYYY
Gender of Child
Age of child when diagnosed with Autism Spectrum Disorder
Does your child(ren) have a current IFSP or IEP? If so, with what Early Intervention Program or public school district?
List some concerns and goals you have for your child(ren).
How did you hear about D.A.T.S. M.O.M.?
What is your child’s and/or family’s most important need right now?

Disability as an Ability Toward Success: Moms on the Move

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This site is made possible by a grant from the Alabama Council on Developmental Disabilities