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Roundtable Registration
FOCUS Individual Member - please enter your REGISTERED membership email
FOCUS School/Corporate Member - please enter your SCHOOL /CORPORATE email
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Email
*
Your email
Are you a FOCUS member?
*
Yes - Indvidual Member
Yes - School Member
Yes - Corporate Member
Lapsed Member
No
Salutation
*
Ms.
Mrs.
Mr.
Dr.
Prof.
First Name
*
Your answer
Last Name
*
Your answer
Contact Number
*
e.g. 1234 5678
Your answer
Are you bringing guest(s)?
*
Yes
No
Total number of attendees (including yourself)
*
1
2
3
4
Required
Guest's Name
Please provide full name of your guest(s) and add a "," comma if you bring more than one guests.
Your answer
Please provide the below information which will help us to better group liked interests when appropriate.
From what perspective are you attending this session?
*
Parent
Educator
Medical Professional
Please choose from below if you are attending this event as an educational or healthcare professional?
Choose
SEN Teacher
Class Teacher
School Administrator
Agency Counselor
Private Tutor
Other Education Professional
Psychologist
Psychiatrist
Paediatrician
Speech Therapist
Other Healthcare Professional
What is the child/student age you are mostly concerned about?
*
Primary School
Secondary School
Post Secondary
Biggest challenges
*
Please share one or two of your biggest support challenges and give details of your situation as if you were explaining to a friend. We will not share individual personal information but we might use it as anonymous examples.
Your answer
Tell us two things you want to learn or get support from this event.
Your answer
How did you learn of this event?
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Email
Website
Facebook
Friend
School
Other:
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