Join the Foundation form

From receiving a newsletter with up to date information or to becoming involved in other ways, fill in the form below to join the Foundation - take the first step!

Your Name: *

Your Email: *

Your Address: (please include city)

Phone number (Home):

Phone number (Work):

Phone number (Mobile):

Are you:

If a parent, please supply your child's details (full name, age):

Do you already belong to a support group in your area?
Yes
No

If so, please give details and contact number/email:

Would you like information on support groups?
Yes
No

Is there any other guidance or advice we can assist with (example, problems at school?)

Referral - where did you find out about the Foundation?

In terms of the Unsolicited Electronic Messages Act 2007, the Cloud 9 Children’s Foundation is required to check with you to confirm whether you want to receive correspondence from us via email. We will have your email address on our database and we aim to only contact you for the purposes of keeping you in touch with activities of Cloud 9 Children's Foundation and related services. If you do not wish to be on our mailing list, you need to clearly indicate this below. However, if you wish to receive e-mail correspondence from Cloud 9 Children's Foundation, do not tick the box.
I wish to receive any correspondence by email ____
I do NOT wish to receive any correspondence by email ____

Cloud 9

Children's Foundation, New Zealand