Neurodevelopmental Awareness Program (NAP) Registration Form

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Neurodevelopmental Awareness Program (NAP) Registration Form

Welcome!

Thank you for showing your interest to connect with the Neurodevelopmental Awareness Program (NAP) by The PADUKA. Our mission is to foster societal awareness about children and adults with neurodevelopmental conditions and to promote acceptance, while activity promoting acceptance, inclusion, and robust support system for their families. Together, we can build a more aware, inclusive, and compassionate society for children and adults with neurodevelopmental conditions. 💙

Registration Fee: Free/ No Charge

Email *

Record my email address with my response

Full Name *

Do you have Email Account? *

Yes

If Yes, Email Id

Country

Contact Number *

Do you have Instagram Account ?

Yes

Clear selection

If Yes, Instagram Id

Do you have Facebook Acount?

Yes

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If Yes, Facebook Id

Profession/Role: (e.g., Parent, Educator, Healthcare Professional, Student, or Self-Advocate)

Why do you want to join this program?

I want to learn the basics.

I want spread awareness about special need children

Clear selection

Would you like to attend more programs like this in the future?

Yes

Maybe

Clear selection

Do you have any children / Adult with special need?

Yes

Clear selection

How much do you already know about this topic

I know nothing or very little.

I know a few things.

I already know a lot.

Clear selection

Would you like to volunteer or support PADUKA’s awareness activities?

Yes

Maybe

Clear selection

Send me a copy of my responses.

Submit

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