Membership

Your Details

First Name (required)

Last Name (required)

Address (required)

Telephone / minicom

Email (required)

Validate Email (required)

Your Children

First Child

Child's Name

Date of Birth

Hearing Loss

Do they use a hearing aid/cochlear implant?
please selectyes, hearing aidsyes, cochlear implantyes, BAHAno, none

Method of communication

Current School

Second Child

Child's Name

Date of Birth

Hearing Loss

Do they use a hearing aid/cochlear implant?
please selectyes, hearing aidsyes, cochlear implantyes, BAHAno, none

Method of communication

Current School

Any other brothers/sisters? Please give details

SDCS sends out email flyers to advertise our events...

Are you happy to be on our email list?
yesno

Do you work with deaf/hearing-impaired children?

Your profession and location Please give details