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SENDCode 'Love Digital Family' Registration Form
Sign up to reserve a space for your family at Holyoake House, M60 0AS on 5th April 10am to 2pm
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1
Child Name
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First Name
Last Name
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2
Birth Date
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Month
Day
Year
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3
Name of School/ Post 16 Placement
*
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4
Parent/Guardian Name
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First Name
Last Name
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5
First Line of Address
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6
Postcode
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7
Phone Number
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8
E-mail
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9
Number of people attending from your household including the young person with SEND.
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4
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10
Please tell us any information that will help us support you by clicking any conditions below that apply.
ADHD
Autism
Attachment Disorder
Dyscalculia
Dyslexia
Dyspraxia
Hearing Impairment
Physical Disability
Sensory Difficulties
Visual Impairment
Other - please type on next card
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11
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