We are looking for people living in the United States or Canada who are interested in dating.
We are interested in hearing from people on the autism spectrum, as well as those who are not autistic but open to dating someone who is.
Anyone may apply, whether or not you identify as neurodivergent. The autism spectrum is incredibly diverse, just like the neurotypical population!
First Name *
Last Name *
City *
State/Province *
Date of Birth *
Email *
Phone Number
How do you identify of the below options? *
What is your gender identity? *
If you selected "prefer to describe," please explain:
Which of the following best describes how you identify? *
If "Other," please explain:
Which race or ethnicity best describes you? *
If "Other," or "Prefer to self disclose," you may explain here:
Are you single and interested in dating? *
Brief description of yourself:
Please attach a photo of yourself *
Please record a short video introducing yourself (this is optional, but suggested!)
