a. Name of child/young person
(Contact details of relevant person) b. Address, c. Email, d. Phone number

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* 1. a. Name of child/young person
(Contact details of relevant person) b. Address, c. Email, d. Phone number

Age of child/young person

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* 2. Age of child/young person

Child/young person hearing status

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* 3. Child/young person hearing status

Child/young person's preferred communication method (can choose multiple)

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* 4. Child/young person's preferred communication method (can choose multiple)

Child young person wear any hearing devices?

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* 5. Child young person wear any hearing devices?

Has anyone in your group attended BSL classes before?

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* 6. Has anyone in your group attended BSL classes before?

Do you think family BSL classes would be beneficial and make a big difference to your child/you/your group

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* 7. Do you think family BSL classes would be beneficial and make a big difference to your child/you/your group

which class group would your prefer?

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* 8. which class group would your prefer?

Can you attend all the dates of your chosen class?

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* 9. Can you attend all the dates of your chosen class?

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