會員申請 old

Interest 興趣

Child's Date of birth 孩子出生日期 *

Father/Guardian's Date of birth 父親/監護人出生日期

Mother/Guardian's Date of birth 母親/監護人出生日期

Mother/Guardian's Mobile Phone 母親/監護人手機

Home Address 地址

Home Phone 住家電話

Child's Chinese name 孩子中文名

Mother/Guardian English name 母親/監護人英文名

Gender 性別 *

Male 男

Female 女

Child's Mobile Phone 孩子手機

Child's Email 孩子電郵 :

Check here to receive email updates

If choose Others, please provide more details below / 如果選擇其他，請在下面提供詳情

Disability 殘疾資料

special needs 特殊需要

Intellectual disability 智障

Poor motor coordination 行動遲緩

Developmental delay 發展遲緩

Autism 自閉症

Speech Delay 語言發展遲緩

Other 其他

Father/Guardian Chinese name 父親/監護人中文名

Child's English name 孩子英文名

Father/Guardian's Email 父親/監護人電郵 :

Check here to receive email updates

Mother/Guardian Chinese name 母親/監護人中文名

Father/Guardian English name 父親/監護人英文名

Mother/Guardian's Email 母親/監護人電郵:

Check here to receive email updates

Father/Guardian's Mobile Phone 父親/監護人手機

Chinese Parents Association – Children With Disabilities Inc. Registered NDIS Service Provider