Who is this application for?
I am applying for myself
I am applying on behalf of someone else
Please note that fields indicated with a red
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are requires fields.
ELIGIBILITY CRITERIA
Anyone who wishes to register for STL Compagnon must meet all the eligibility criteria below. To confirm that all the criteria have indeed been met, check off each of the following boxes.
Aged 12 or older.
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Have at least one of these conditions:
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- Autism spectrum disorder (ASD)
- Mild intellectual disability (MID)
- Developmental language disorder (dysphasia)
Have a relationship with at least one of the following organizations:
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- CISSS de Laval
- Regroupement des organismes de promotion de personnes handicapées de Laval (ROPPHL)
- Autisme Laval
- Centre de service scolaire de Laval (CSSL)
- Sir Wilfrid Laurier School Board (SWLSB)
Please specify which organization(s):
CISSS de Laval
Regroupement des organismes de promotion de personnes handicapées de Laval (ROPPHL)
Autisme Laval
Centre de service scolaire de Laval (CSSL)
Sir Wilfrid Laurier School Board (SWLSB)
Capable of all of the following:
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- Walk on the sidewalk
- Recognize bus stops
- Differentiate between moving cars and parked cars
- Cross the street safely (crosswalks, green light, being vigilant, etc.)
- Commute in bad weather
- Stay standing if there are no free seats on the bus
- Able and open to learning how to use a smart phone
- Able to express yourself and have relatively good hearing
PERSON REGISTERING TO USE STL COMPAGNON
First name
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Last name
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Email
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Postal code
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Cellphone
Other phone
CONTACT PERSON/GUARDIAN
Contact person’s first name
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Contact person’s last name
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Contact person’s email
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Contact person’s phone number
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Read the Privacy Policy and Terms of Use
I have read and agree to the Privacy Policy and the Terms of Use, and I agree to let the STL share basic information about me or about the person for whom I am registering with authorized individuals.
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