GROUP Program EOI Form

Social and Life Skills Groups Expression of Interest

Child's first name *

Child's last name *

Child's date of birth *

What grade is your child in this year? *

What grade is your second child in this year? *

What location are you interested in attending a group at? (please select all that apply) *

Brisbane - AshgroveGold CoastSunshine CoastTownsville

Which session do you wish to attend?

AprilJulySeptemberNo preference

Which session do you wish to attend?

JuneOctoberNo preference

Parent / carer first name *

Parent / carer last name *

Email address *

Phone number

Do you have a NDIS plan? *

YesNo

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