How Do You Belong? Pilot Program Interest Form
How Do You Belong? is a free 6-week programme for parents and carers of deaf children aged 0 to 5. Together we'll explore belonging, deaf identity, confidence and practical ways to help your child grow up feeling proud, understood and connected. You'll also have the opportunity to meet other families in a warm, supportive and inclusive environment. We’re so glad you’re interested! Please share a little about your family and needs so we can make this program as welcoming and accessible as possible. All questions are optional unless marked required.
Parent/Guardian Full Name
First Name
Last Name
Contact Phone Number
-
Area Code
Phone Number
Email Address
example@example.com
Area You Are Based
Do you have any accessibility requirements?
Do you need an interpreter?
Yes
No
If yes, please specify the language or type of interpreter needed
Do you have a deaf or hard of hearing child aged 0–5?
*
Yes
No
What’s your preferred way to attend?
In-person group in Tipton DY4 9DD, Tuesdays 10am–12pm, 6 weeks starting 22nd September
Online group in October, Tuesdays 10am - 12pm, 6 weeks starting Tuesday 6th October
Either is fine
Are you able to attend the full 6-week program
Yes
No
Unsure
Is there anything else you’d like us to know, or any questions you have?
Register Interest
Should be Empty: