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* 1. What is your first name:

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* 2. What is your last name:

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* 3. What telephone number would you like to be contacted on:

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* 4. What email address would you like to be contacted:

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* 5. Which which course are you interested in:

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* 6. Are you a member of Clair’s Parents Meeting Parents ADHD:

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* 7. Do you care for a child or young person with ADHD:

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* 8. Do you have any support or access needs:

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