email address:

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* 1. email address:

Telephone number:

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* 2. Telephone number:

Your name:

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* 3. Your name:

Child's name:

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* 4. Child's name:

Child's age:

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* 5. Child's age:

Does your child have a diagnosis of autism?

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* 6. Does your child have a diagnosis of autism?

Is your child in:

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* 7. Is your child in:

Do you have any particular question?

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* 8. Do you have any particular question?

I can attend on 29th August or 14th September in Bracknell, Berkshire

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* 9. I can attend on 29th August or 14th September in Bracknell, Berkshire

If Yes, how many parents would want to attend

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* 10. If Yes, how many parents would want to attend

If No, I may be able to attend on a date in:

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* 11. If No, I may be able to attend on a date in:

I will come by:

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* 12. I will come by:

T