As a way of providing support and advice to families and introducing you to the IHC Library, we would like to give you a free book relevant to your child's needs.

Your full name.

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* 1. Your full name.

Name of child

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* 2. Name of child

Age of child or family member

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* 3. Age of child or family member

Home address

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* 4. Home address

Phone number

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* 5. Phone number

Email address

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* 6. Email address

Tick box if you DON'T want to receive information about what IHC is doing.

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* 7. Tick box if you DON'T want to receive information about what IHC is doing.

The most relevant book for my child is..(please tick - one book per family)

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* 8. The most relevant book for my child is..(please tick - one book per family)

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