Take Part

I would like to take part!


Parent Name

Infant Name

Date of Infant's Birth
Day: Month: Year:

Girl Boy 

Are you interested in:
Postal participation?  Yes No
Internet participation?  Yes No
Personal participation?  Yes No
(ie. focus groups or taking part at a University)

Your Address (required)

Your Postcode (required)

Your Mobile Phone

Your Home Phone

Your Work Phone

Your Email (required)

Comments/Questions You'd Like to Ask

How did you hear about the UK-CDI project? please tick the appropriate box:

If you have received a leaflet when you heard about the study, please give leaflet code at the bottom of the sign up form

All personal information processed by the University is stored securely and processed in accordance with the Data Protection Act and Ethics guidelines.