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Enrolments will help us keep in touch with you and update you on our Workshops and Programs which are by and large Free of Cost.  There is no fee to join VConnect Foundation, though donations are more than welcome in order to support our activities, so go ahead and enrol.

Child's Name* Date Of Birth Centre
 
School Medium  
 
Hearing Loss RT LT HA Model Type of Implant
 
Father's Name Mother's Name Siblings
 
Email id*
 
Address
 
Tel Nos Res:  
 
  Off:  
 
  Mob:  
 
Voluntary Contribution to start the Support Group  
 
Expectations of the Support Group
 
 
 
 
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