Register with PACT

Thanks for your interest in joining us. You'll be pleased to hear that joining is free and by registering using this form, you'll be receive our regular newsletters, keeping you updated with current information, and giving you access to events, days out and much more.

A quick note about privacy:

Anything that you submit on this form will be seen by certain members of PACT for Autism for administrative and planning duties. You can read our Privacy Policy here.

We will never pass your details to any other third party unless:

We have your permission, or,
We are required to do so by law.

PACT Registration Form

This section is about you.

First Name

Last Name

Address 1

Town

County

Postcode

Telephone:

The next section will cover details of your dependants. We use this information to plan appropriate support, signposting and activities that will meet the needs of as many people as we can. We encourage you to enter the details of all people that may benefit from our services , whether they have additional needs or not.

You can add up to four dependants here.

By dependant, we mean children, young adults, or adults that you think might benefit from our activities.

Dependent #1 Details:

Dependent 1 First Name

Dependent 1 Last Name

Dependent 1 Date of Birth

Dependent #2 Details:

Dependent 2 First Name

Dependent 2 Last Name

Dependent 2 Date of Birth

Dependent #3 Details:

Dependent 3 First Name

Dependent 3 Last Name

Dependent 3 Date of Birth

Dependent #4 Details:

Dependent 4 First Name

Dependent 4 Last Name

Dependent 4 Date of Birth

General Information

I confirm that I am happy to be contacted by PACT.

That's it! Thanks for taking the time to fill in this form.

You should receive a welcome email with key information and useful contacts.

Please check your 'SPAM' box and add us to your contacts

Thanks for submitting!

Parents Adults and Children Together

Register with PACT

PACT Registration Form

Dependent #1 Details:

Dependent #2 Details:

Dependent #3 Details:

Dependent #4 Details:

General Information

That's it! Thanks for taking the time to fill in this form.

You should receive a welcome email with key information and useful contacts.

Please check your 'SPAM' box and add us to your contacts

PACT is proud to work with, and be supported by:

Parents Adults and Children Together

Register with PACT

PACT Registration Form

Dependent #1 Details:

Dependent #2 Details:

Dependent #3 Details:

Dependent #4 Details:

General Information

That's it! Thanks for taking the time to fill in this form. You should receive a welcome email with key information and useful contacts. Please check your 'SPAM' box and add us to your contacts

That's it! Thanks for taking the time to fill in this form.

You should receive a welcome email with key information and useful contacts.

Please check your 'SPAM' box and add us to your contacts