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Participant Name
Participants need to be between 5 and 14 years old.
Does the participant identify as Aboriginal or Torres Strait Islander?
Parent/Guardian 1 Name
Parent/Guardian 2 Name
Is there a language other than English spoken at home?
If yes, which language/s?
Does the participant have a current NDIS plan?
If yes, what is their Participant Reference Number?
How is the participant's NDIS plan managed?
If plan-managed, please include the name and contact details of the plan manager