BranchExpansion

Branch Expansion

We at Spina Bifida Hydrocephalus Ireland Kildare Branch are hoping to expand the Branch to cover the counties of Carlow, Laois & Offaly.
Some of the services we offer our members and detailed here
If you are interested in becoming a part of the expanding SBHI Kildare Branch please complete this form by the 4th of May

* Indicates required field

Name of person with Spina Bifida or Hydrocephalus *

First

Last

Guardian Name *

First

Last

Address *

Email *

If you are happy to recieve messages from the branch messaging service please insert mobile phone number *

Are you currently a registered company member of SBHI? *

Yes No (but willing to register) No (not willing to register)

We may be able to provide some financial support for attendance at the 2018 SBHI AGM and conference. Are you interested in attending? *

Yes No

How many adults in total would be attending? *

How many children in total would be attending? *

Are you interested in assisting the Branch with fundraising, church gate collections, helping out with organising etc? *

Any other comments you wish to make *

Submit