Registration
Form
I wish to register to attend the Growing-Minds course.
I have enclosed a cheque (£’s sterling only) for
the Name/s............................................................................................................................................................................................... Address............................................................................................................................................................................................... Postal code.................................................................................. Country........................................................................................ E-mail................................................................................................................................................................................................... Phone.............................................................................................. Fax............................................................................................ Signature............................................................................................................................ Date....................................................... Are you a parent, professional, volunteer or Other: Explain:............................................................................ Child's Name..................................................................................................................Their DOB................................................... What is their diagnosis?...................................................................................................................................................................... Are you currently teaching your child at home? Yes
No If yes, what type
of program are you working with? Do you have any special dietary requirements? Yes No Where did you hear about this course? ......................................................................................................................................... Please mail to: Eileen Chiverton,
The TRUE Group |