Clone of Workshop Registration Form

Please join us on Tuesday, May 26 from 7:30-8:30pm for our next remote Family Connection Series! Two families will share their parenting journeys of raising their children who are Deaf or hard of hearing.

Name

First NameLast Name

E-mail

example@example.com

Phone Number

Format: (000) 000-0000.

Child/Children's Date(s) of Birth

How did you hear about our Family Connection Series?

Would you like to be contacted about future events?

Do we have your permission to communicate with NH's Early Hearing Detection & Intervention Program based at the NH Dept of Health and Human Services regarding your family's participation in our Program?

Signature