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Central Bedfordshire Council
Accessibility Help
Parent Self Referral
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Your Details
Thank you for choosing to contact Central Bedfordshire SEND Information, Advice and Support Service (SENDIASS) We are an impartial, confidential service working at arm's length within CBC. Please complete the following form and we will contact you shortly.
Name
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Child/Young Person Name
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Child/Young Person DOB
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Day
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Month
Month
January
February
March
April
May
June
July
August
September
October
November
December
Year
School
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Telephone
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E-mail address
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Address
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Postcode
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General enquiry
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What is your ethnic group?
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White
Mixed or Multiple ethnic group
Asian or Asian British
Black, African Caribbean or Black British
Other ethnic group
Prefer not to say
White
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English, Welsh, Scottish Northern Irish or British
Irish
Gypsy or Irish Traveller
Any other white background
Mixed or Multiple ethnic group
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White and Black Caribbean
White and Black African
White and Asian
Any other Mixed or Multiple ethnic background
Asian or Asian British
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Indian
Pakistani
Bangladeshi
Chinese
Any other Asian Background
Black, African Caribbean or Black British
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African
Caribbean
Any other Black, African or Caribbean background
Other ethnic group
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Arab
Any other ethnic group
Other
(Value If Not In List)
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