Support Parent training

registration form

0508 236 236 | national@parent2parent.org.nz | www.parent2parent.org.nz

Are you registering for refresher training?

Yes No

Region*

Please select your region

Name*

First Name

Last Name

Address

Address Line 1

Address Line 2

City

State/Province

ZIP / Postal

Phone number*

Email*

Gender*

Female Male Other

Please indicate the main disability of your child/family member*

Physical Intellectual Sensory Autism spectrum disorder

Other:

Are you happy for Parent to Parent to take photos for promotional purposes?*

Yes No

How did you find out about the Support Parent course?*

Your regional branch Parent to Parent eNews Parent to Parent website Facebook and other Social Media Agency referral Newspapers or other print media

Other:

Have you attended any previous training with Parent to Parent*

Yes No

This includes the Care Matters Renew Workshop

If yes, please specify

Please list any special dietary requirements

To keep our training accessible, please let us know if the following could be an issue for you

Sight - reading standard text Hearing

Other: