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Home
About Us
Our Story
Our Philosophy
Our Team
Our Supporters
Services
What We Do
Fees
Conductive Education
Classes
Sensory Kindy
Resources
Testimonials
Testimonials
Donations
Donations
Contact Us
DT Contact Test
Parent's details
First name: *
Last name: *
Phone:
Mobile:
Email:
Address
Address line 1:
Address line 2:
City:
Postcode:
Country:
select country
Afghanistan
Åland Islands
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia (Plurinational State of)
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Caribbean Netherlands
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini (Swaziland)
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and Mcdonald Islands
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, North
Korea, South
Kosovo
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia North
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar (Burma)
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey (Türkiye)
Turkmenistan
Turks and Caicos Islands
Tuvalu
U.S. Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City Holy See
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
How did you hear about us?
select option
Advert
Advertising in local newspaper
Another centre
Another parent
Flyer
Hotel Reception
Internal transfer
Local School
Parent & child show
Previously enrolled sibling
Signage
Staff member
Television Advertising
Website
Word of mouth
Questions or Comments (Does your child have a diagnosis/in the process of receiving one? If so, list any/al):
Child details:
First name: *
Last name: *
Middle name: *
Ethnicity:
select ethnicity
New Zealand European
Maori
Afghan
African
African American
Afrikaner
Albanian
Algerian
American
Anglo Indian
Arab
Argentinian
Armenian
Asian
Assyrian
Australian
Austrian
Bangladeshi
Belgian
Belorussian
Bengali
Bhutanese
Bolivian
Bosnian
Brazilian
British
Bulgarian
Burmese
Burundian
Cambodian
Cambodian Chinese
Canadian
Caribbean
Celtic
Channel Islander
Chilean
Chin
Chinese
Colombian
Congolese
Cook Islands Maori
Cornish
Croatian
Cypriot
Czech
Dalmatian
Danish
Dutch
Ecuadorian
Egyptian
English
Eritrean
Estonian
Ethiopian
Eurasian
European
Fijian
Fijian Indian
Filipino
Finnish
Flemish
French
German
Ghanaian
Greek
Romani
Hawaiian
Hong Kong Chinese
Hungarian
Icelandic
Indian
Indian Tamil
Indigenous American
Indigenous Australian
Indonesian
Iranian/Persian
Iraqi
Irish
Israeli/Jewish
Italian
Jamaican
Japanese
Jordanian
Karen
Kenyan
Kiribati
Korean
Kurd
Lao
Latin American
Latvian
Lebanese
Lithuanian
Macedonian
Malay
Malaysian Chinese
Malaysian Indian
Maldivian
Maltese
Manx
Mauritian
Mexican
Middle Eastern
Mongolian
Moroccan
Nauruan
Nepali
New Caledonian
New Zealander
Ni Vanuatu
Nigerian
Niuean
Norwegian
Other Ethnicity
Other South African
Other Zimbabwean
Pacific Peoples
Pakistani
Palestinian
Papua New Guinean
Peruvian
Pitcairn Islander
Polish
Portuguese
Puerto Rican
Punjabi
Romanian
Rotuman
Russian
Samoan
Scottish
Serbian
Seychellois
Sikh
Singaporean Chinese
Sinhalese
Slavic
Slovak
Slovenian
Solomon Islander
Somali
South African European
South African Indian
South Slav
Southeast Asian
Spanish
Sri Lankan
Sri Lankan Tamil
Sudanese
Swedish
Swiss
Syrian
Tahitian
Taiwanese
Thai
Tibetan
Tokelauan
Tongan
Turkish
Tuvaluan
Ukrainian
Uruguayan
Venezuelan
Vietnamese
Vietnamese Chinese
Welsh
Zambian
Zimbabwean European
Refused to Answer
Repeated Value
Response Unidentifiable
Response Outside Scope
Don't Know
Not Stated
Home Language:
select language
English
Māori
Afrikaans
Albanian
American Sign Language
Amerind
Amharic
Arabic
Armenian
Artificial Languages
Artificial Languages not elsewhere classified
Assyrian
Australian
Australian Sign Language
Azeri
Bahasa Indonesia
Baltic
Baltic not elsewhere classified
Bantu
Bantu, not elsewhere classified
Basque
Belorussian
Bengali
Bisayan
Bislama
Breton
British Sign Language
Bulgarian
Burmese
Yue
Catalan
Caucasian
Caucasian not elsewhere classified
Cebuano
Celtic
Celtic not elsewhere classified
Central Pacific
Central Pacific not elsewhere classified
Chadic
Chadic not elsewhere classified
Cook Islands Maori
Creole
Cushitic
Cushitic not elsewhere classified
Czech
Danish
Dravidian
Dravidian not elsewhere classified
Dutch
Esperanto
Estonian
Fiji Hindi
Fijian
Finnish
French
French Creole
Friesian
Fulani
Georgian
German
Greek
Gujarati
Hakka
Hausa
Hebrew
Hindi
Hindi Bat
Hungarian
Icelandic
Ilokano
Indo-Aryan
Indo-Aryan not elsewhere classified
Iranian
Iranian not elsewhere classified
Irish
Italian
Japanese
Javanese
Kannada
Kashmiri
Khmer
Kiribati
Konkani
Korean
Kurdish
Language Isolates not elsewhere classified
Lao
Latvian
Lithuanian
Macedonian
Malayalam
Malaysian
Maltese
Moriori
Northern Chinese
Marathi
Mauritian Creole
Miao-Yao
Micronesian
Micronesian not elsewhere classified
Min
Mon-Khmer
Mon-Khmer not elsewhere classified
Nauruan
Neo Melanesian
Nepalese
New Zealand Sign Language
Nilo-Saharan
Niuean
North Germanic
North Germanic not elsewhere classified
Norwegian
Oriya
Other Miscellaneous Languages
Other Niger-Congo
Other Niger-Congo not elsewhere classified
Papuan
Pashto
Persian
Pidgin English
Pidgins and Creoles
Pidgins and Creoles not elsewhere classified
Polish
Portuguese
Pukapukan
Punjabi
Romance
Romance not elsewhere classified
Romani
Romanian
Rotuman
Russian
Samoan
Scots
Scottish Gaelic
Semitic
Semitic not elsewhere classified
Serbo-Croatian
Shan
Sign Language
Signed English
Sindhi
Sinhala
Sinitic
Sinitic not elsewhere classified
Slavic
Slavic not elsewhere classified
Slovak
Slovene
Solomon Islands Languages
Solomon Islands Pidgin
Somali
Spanish
Swahili
Swedish
Tagalog
Tahitian
Tai-Kadai
Tai-Kadai not elsewhere classified
Tamil
Telugu
Thai
Tibetan
Tibeto-Lolo-Burman
Tibeto-Lolo-Burman not elsewhere classified
Tieu-Chow
Tigrinya
Tok Pisin
Tokelauan
Tongan
Turkish
Turko-Altaic
Turko-Altaic not elsewhere classified
Tuvaluan
Ukrainian
Uralic
Uralic not elsewhere classified
Urdu
Vanuatu Languages
Viet-Muong
Viet-Muong not elsewhere classified
Vietnamese
Welsh
West Germanic
West Germanic not elsewhere classified
Western Malayo-Polynesian
Western Malayo-Polynesian not elsewhere classified
Wu
Yiddish
Yoruba
Zulu
None (eg too young to talk)
Don't know
Refused to answer
Response unidentifiable
Response outside scope
Not Stated
Gender:
select gender
Male
Female
Unknown
Date of Birth: