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* 1. Would you like to attend Speech & Language Sessions from September 2018 - July 2019? 

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* 2. Please give us your child or young person's name and date of birth so that we can plan appropriate groups.

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* 3. Please let us know what days & times you can attend sessions. 

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* 4. Please let us know if there is anything you would particularly like to see incorporated into the sessions. 

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* 5. Please give us your contact email & te´╗┐lephone number so that we can let you know when the sessions will be and send reminders.
NB: This information will not be shared with anyone else and will only be used to let you know about Speech & Language sessions. 

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