NUS Infant & Child Language Centre

Interest Form

All information provided will be strictly confidential. Filling out this form is merely an indication of your interest in our research and no information will be used without your prior consent. 

Please fill out the following form and we will get back to you about our studies and any enquiries which you may have. 

What is your child's name?
What is your child's date of birth (DD/MM/YYYY)?
What is your child's gender?
Which language(s) and dialect(s) is your child exposed to?
e.g. English, Chinese and Cantonese
What percentage of each language is your child directly exposed to? (Total = 100%)
e.g. English - 60%, Mandarin - 30%, Cantonese - 10%
What is your name?
What is your relationship to the child?
What is your contact number?
What is your email address?
What is your preferred mode of contact?
How did you hear about us?
Your comments/enquiries

Thank you! We will be in touch with a study that is appropriate for your child's age and language group.


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