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  • 1. Name and Contact details

    The questions with an asterisk * are mandatory

  • Phone Numbers
  • Preferred contact method:  *
  • Other preferred contact methods:
  • 2. Your online community login details

  • 3. About you 

  • Gender:  *
  • 4. Accessibility needs and assistive technology

  • Sensory needs:
  • Physical needs:
  • Cognitive and mental health needs:
  • Communication needs:
  • Chronic health needs:
  • Other
  • Digital and screen technologies, including hardware:
  • Movement, canes and service animals:
  • Communication, verbal and written preferences:
  • Personal support and home:
  • Other