GROUP FORM

Does the child/young person/young adult have a diagnosis of Down's syndrome. *

YES

NO

Parent/Carer Name *

If the person applying to attend is over 18 and is applying themselves this can be left blank and we will contact them directly with all information.

First Name

Last Name

Child/young person/young adults name *

The person with Down's syndrome.

First Name

Last Name

Date of birth *

MM

DD

YYYY

Which group / service are you interested in? *

Tick all that apply

Little Stars 0-2 years (babies)

Rising Stars 2-4 years (pre-school)

Shooting Stars 4-7 years (infants)

Super Stars 7-11 years (juniors - previous communication groups)

S-Club Sessions 11-18 years

S Club + 19-25 years

Speech Clubs (3-day sessions during holidays)

What setting do they attend? *

None - below school/nursery age

Nusery/pre-school

Primary Education - Mainstream

Primary Education - Specialist, unit or similar

Secondary Education - Mainstream

Secondary Education - Specialist, unit or similar

College - Mainstream

College - Specialist

Not in education setting and over 16

Home Schooling - Primary Education

Home Schooling - Secondary Education

Does the child/ young adult have an EHCP *

YES

No

IN ASSESSMENT STAGE

Which Centre location are you interested in *

Please note Speech Clubs move around the county and are not solely located in either Centre

Maidstone

Margate

Both

Is your interest a firm intention of attending or a general enquiry and request to receive information about upcoming spaces? *

Firm interest suggests that if offered a place you would be very highly likely to take it up.

Firm Interest

Waiting List Enquiry