澳洲弱能兒童協康會

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

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Membership Application and Renewal Form

Please complete the form below to renew or apply for a membership. The membership fee is $10.00 p.a (inc.GST).

Once the form is completed, please send us a signed copy with your cheque/money order to: 

Chinese Parents Association - Children With Disabilities Inc. 
PO Box 345, Campsie NSW 2194

By completing and submitting the form below, you agree that you would like to enrol as a member of the Chinese Parents Association - Children With Disabilities Inc

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

Your child's details

孩子資料

if you don't have disabled child, you can only become affiliate member

如果你沒有弱能孩子，你只能成為附屬會員

Mother/guardian details

母親/監護人資料

Father/guardian details

父親/監護人資料