HPCN

First Name *

Last Name *

Email Address *

Consent to store your information *

Yes
No

Due to data protection regulations (GDPR) we cannot add you as a member unless you tick "yes"

Area of Hampshire you live in or are interested in *

Area you live in or represent

First 4 characters of your postcode *

Which age bracket do you fall into? *

Which describes your Heritage *

Any other Heritage please describe

Which describes your Gender Identity *

If other please describe

Do you think you have Neurodiversity or disability *

If yes please describe

Which Describes your religion *

If other, please describe

Which describes your Sexual Orientation *

If other please describe

Is your child entitled to free school meals? *

NB: Your child may be able to get free school meals if you get any of the following: Income Support income-based Jobseeker’s Allowance income-related Employment and Support Allowance support under Part VI of the Immigration and Asylum Act 1999 the guarant

If Other (please specify)

NB: Your child may be able to get free school meals if you get any of the following: Income Support income-based Jobseeker’s Allowance income-related Employment and Support Allowance support under Part VI of the Immigration and Asylum Act 1999 the guarant

Information on local Get Together sessions?

Yes
No

Would you like to be sent one email a month about your local Get Together sessions? These are friendly sessions to meet other local parent carers

Information on local Future in Mind sessions?

Yes
No

Would you like to be sent a reminder and session notes for your local Mental Health session ‘Future in Mind? These are suitable if you are on the CAMHS waiting list or have a child/young person who needs support with their emotional wellbeing.