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| DYNAMIS Seminar and consultation booking/Seminaar en konsultasie | 
| Seminar and Date: | |
| Deposit paid date: | Amount paid: | 
| Reference is Surname and Seminar Date | |
| Name and Surname: | Town / City: | 
| Tel No: | Cell No: | 
| Fax No: | Email Address: | 
| * Doing Home Education Already? | * Number of Years? | 
| * On what system: | Languages? | 
| Number of children? | |
| I am interested in the following areas | |
| Why Home Education? | |
| Associations for home education | |
| Support Groups | |
| Matriculation | |
| Registration with the government | |
| Legal fund for home education | |
| Socialisation and sport | |
| Learning Problems | |
| Presentation in your community | |
| Personal consultation for help | |
| Information on curricula | |
| Parents training in help with special needs or learning problems | |
| Other Needs: | Your biggest need at present: | 
| How did you hear about us: | |