When registering to participate in research at of Olga Tennison Autism Research Centre, the details you provide will be stored in our database salesforce.com with emails sent via our email marketing platform MailChimp.
If you wish to have your details removed from our database, please contact email@example.com or 03 9479 3271.
If you are a parent registering your child, please provide your child's details here.
First Name (Required):
Last Name (Required):
Date of Birth (Required):
Diagnosis - Please tick all applicable (Required):
You can select one or both of the options below:
I would like to register for the OTARC Research Participant Registry. I understand that my details will be included in the Registry and passed on to relevant researchers.
I would like to register for the following research studies. I understand that my details will be passed on to relevant researchers. (Enter the study code(s) for each study you are interested in, separated by a comma. Our current studies are listed below):
City / suburb (Required):
Post code (Required):
I am registering myself. I am over 18 years of age.
I am the legal parent, guardian or carer of:
(Please provide your name)
Guardian Given Name:
Guardian Family Name:
I would like to receive further information from the Olga Tennison Autism Research Centre
(e.g., quarterly e-Newsletter, Autism news alerts, news and information on upcoming seminars and workshops)