Membership Form

By including your email address, you will go onto our online database and be emailed details of events, meetings etc.  If you would prefer to be contacted by post or telephone just let us know below.

The form asks for details of your child or young person’s school/college and year group.  This information is used to identify gaps in the membership of our group and so that we can identify similar issues within similar age groups or schools.  If you would rather not tell us, please leave this blank.

Please be rest assured your contact details will not be passed on to anybody else.

 

Your Full Name (required)

Your Address (required)

Your Postcode (required)

Your Email Address (required)

Your Phone Number (required)

How do you want us to contact you? (required) Please select:

Name of Child or Young Person

School

Year Group

Details of disability/additional needs/diagnosis

[recaptcha size:compact]