Family Expression of Interest Form

We look forward to meeting your family!

Please complete the details below, and we will contact you soon.

As many of our programs are at or near capacity, priority will be given to families living in Sydney's Eastern Suburbs. If you live outside this area would still encourage you to complete this form so that you will be first to know when we expand our programming. Additionally there are other social and networking events for families and parents that may interest you. By completing this form we will better understand future demand.

If you have any questions about this form, please email hello@sydneyfc.org.au.

Child's Details

First Name *

Last Name *

Email *

May be the same as the email address of the parent/ guardian completing this form. A copy of your submission will be sent to this email address.

Street Address *

Suburb *

State *

Post Code *

Country *

Date of Birth (MM/DD/YYYY) *

The date needs to be entered in US date format (MM/DD/YYYY). Please use the calendar icon.

Gender *

Please note your child's diagnosis: *

Which school does your child attend? *

How did you hear about Friendship Circle? *

If you selected 'Other' please specify:

If you were referred by a family member or friend, or if you know someone attending Friendship Circle programs, please share their name/s:

Which program/s would you like to know more about? *

Parent/ Guardian 1

Prefix *

First Name *

Last Name *

Email *

Mobile *

Please enter in this format: 614XXXXXXXX

Do you live at the same address as your child? *

Relationship *

Parent/ Guardian 2

Prefix *

First Name *

Last Name *

Email *

Mobile *

Please enter in this format: 614XXXXXXXX

Do you live at the same address as your child? *

Relationship *

Please click the 'Submit' button below and check that you have received a copy of the form submission by email.