Creative Arts Sibling Support

Acknowledging the social & emotional needs of the brothers and sisters who have been touched by autism

Saturdays: April 5 & 12, May 3,10,17 & 31, June 7 and 14, 2008

Fee: Voluntary Donation

Location: The ELIJA House 665 N. Newbridge Rd. Levittown NY 11756

Phone: 516 433 4321

Fax: 516 433 4324

Email: Elija@optonline.net

Approximately 2 hours long and Directed by Licensed and or Board Certified Art & Music Therapists

This is a "drop off" program for the siblings of children with autism, with the exception of the Mommy and Me class

Morning Session 10:00am to 12:00pm

2 groups: For 4-6 year olds & Mommy's with their 3 and younger typically developing child

Afternoon Session 12:30pm to 2:30pm

2 groups: For 7-9 year olds & 10 and up

We will notify you to announce your child's acceptance into this program. Thank you for your interest

---------------------------------------------------------Email, Mail or Fax to Us---------------------------------------------------

Name of Sibling ________________________________________ Age___________

Name of Sibling________________________________________ Age____________

Parent/Guardian Name:______________________________________________________________

Street address:______________________________________________________________________

City:___________________________ State______________ Zipcode__________________________

Contact Number:___________________________________ Email Address:_____________________

Additional Comments:_________________________________________________________________

___________________________________________________________________________________

For future groups we plan to design that will accommodate children with Autism, please submit their information below so that we may better serve them in the future with an appropriate group

Name:____________________________________________ Age______________

Elija Foundation Sibling Support 665 N. Newbridge Rd. Levittown NY 11756 Ph|516 433 4321 Fx|516 433 4324 Email|elija@optonline.net