Next Level Social

Next Level Social application

Next Level Social is for independent adults 21 and older on the autism spectrum. Your answers are private and are only seen by NPower staff.

Who it is for

21 years or older
Holding a job for at least 90 days
Working about 20 hours per week
High school diploma or GED
Able to use a cell phone
Able to take part in social activities independently

About you

Full name

Phone

Address

City

State

ZIP

Date of birth

Age

Emergency contact name

Emergency contact phone

Eligibility I have held a job for at least 90 days I work about 20 hours per week I have a high school diploma or GED I am able to use a cell phone I can take part in social activities independently

Education

Where do you work?

Weekly hours

Job duties

About your interests

Your strengths

Your challenges

How comfortable are you meeting new people?

Hobbies and interests

Are you interested in friendship, dating, or both?

Relationship preferences (optional)

Goals around friendship or dating (optional)

Anything about your experience so far you would like to share (optional)

A few more questions

Did anyone help you complete this application? If so, who?

How did you hear about Next Level Social?

Acknowledgement

I understand that Next Level Social includes social activities, including friendship and dating events, and that these involve emotional and social risks. I agree to take responsibility for my own choices, to treat others with respect, and to speak up if I feel uncomfortable or unsafe. I understand I can ask a trusted adult or NPower staff for support. I understand that NPower Services is not responsible for the actions of other participants, and that taking part also requires the general participation waiver.

I have read and agree to this acknowledgement.

Your answers are private and are only seen by NPower staff. Taking part also requires the general participation waiver.