Membership Form

We have drafted this register to collate as much information about Heart Children as possible.  We would be grateful if you could help.  It will help us to target the needs of both children and parents and would give a clearer picture for the future.

It would especially help to know your child’s name and date of birth.  

Please add on any other information you would like us to know.  Everything will be in strictest confidence.  

If you would like to contact or be contacted by another parent with similar problems please let us know (there will be no contact unless verified by phone first).

Even if you have filled in a form before – update us!

Please return to: Linda Hogan
                       Administrator,
                       The Carmichael Centre, North Brunswick Street, Dublin 7
Telephone:        1850 217 017
Email:               heartchildren@eircom.net
Web site:          www.heartchildren.ie

Heart Children
Register of Member Children’s Details

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