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Email *
Name of Child *
Date of Birth *
Physical address *
Diagnosis or Exceptionality *
School *
Interest or hobbies of your child *
Favorite item or toy? *
Parents name & or Guardian *
Any siblings & ages *
Concerns and worries you may have? *
Main reason you are reaching out today? *
Do you need  any materials & resources for your child? *
Are you open to recieve trainings and attend workshops? Either online or in person? *
Are you open to community & school activities for your child? *
Best way to contact you? *
Tell us all about your family & child. *
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