Kiind Membership| Update Membership

Name of primary contact:*

Surname:*

Known as:

Gender:*

Male

Female

Non-binary / Gender diverse

Prefer not to say

Other

Other:*

Are you of Aboriginal or Torres Strait Islander origin?*

Yes

No

Are you from a culturally and linguistically diverse background?*

Yes

No

Address:

Suburb:

Postcode:*

Telephone:

Mobile:

Email:*

Preferred method of contact:*

Phone

Email

Please indicate if you would like to be connected to any of the options below (if not already):

Please Connect me to

Kiind Families Facebook Network, (closed Facebook group)

My Facebook name is:

Please Connect me to

A trained Kiind Parent Coach

Please Connect me to

I am interested in becoming a Parent Coach

Please Connect me to

Weekly What’s on guide and other updates

Name of secondary contact (if applicable):

Surname:*

Known as:

Gender:*

Male

Female

Non-binary / Gender diverse

Prefer not to say

Other

Other:*

Are they of Aboriginal or Torres Strait Islander origin?*

Yes

No

Are they from a culturally and linguistically diverse background?*

Yes

No

Address (if different):

Suburb:

Postcode:

Telephone:

Mobile:

Email:

Preferred method of contact:*

Phone

Email

None

Please indicate if the secondary contact would like to be connected to any of the options below (if not already):

Please connect secondary to

Kiind Families Facebook Network, (closed Facebook group)

Facebook name is:

Please connect secondary to

A trained Kiind Parent Coach

Please connect secondary to

They are interested in becoming a parent coach

Please connect secondary to

Weekly What’s on guide and other updates

Anything new?
Let us know

Update your membership

Member Update Form

Thank you for updating your details

Anything new? Let us know

Update your membership

Member Update Form

Thank you for updating your details

Anything new?
Let us know