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Worcestershire County Council
Children's Disability and Additional Needs Register
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1
Please select who is completing this registration
Are you?
A parent or carer
A child or young person (If you are 18 years old or over you can add or remove yourself to the register)
A professional (on behalf of child with consent from either Parent / Carer or Young Person themselves if appropriate)
Contact Email Address
This will be used to send confirmation details and certificate for joining register only. It will only be used to contact you if you choose to allow us to at the end of the form.
2
Child or Young Person Details
First Name
Last Name
Date Of Birth
Day
-- Please Select --
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Month
--- Please Select ---
January
February
March
April
May
June
July
August
September
October
November
December
Year
-- Please Select --
2024
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
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2009
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1999
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