Secure your spot in the Melillo Method Mentoring program as a Referral Partner.

This form is for those inviting someone to join the program at a discounted rate.

Referral Partner access is available to individuals who are:

✅ A spouse or co-parent involved in supporting a neurodivergent child

✅ A family member working alongside the primary participant in a caregiving or supportive role

✅ A business partner, colleague, or team member actively involved in delivering services

✅ Directly collaborating with the person who enrolled in the Melillo Method Mentoring Program

✅ Full access to the MMM training.

✅ Mentoring calls with Dr Robert Melillo for 12mths

✅ Access to exclusive resources and professional tools

✅ Monthly Mentoring with a coach for 12mths.

You’ll get hands-on tools, customisable programs, and real-time support—not just content, but confidence.

💡 Please note: This access is for one individual and is not transferable or shareable.

This may include co-practitioners, therapy assistants, educators, admin/support team members, or parents working together to support their child.

*The person referring someone

First Name *

Last Name *

Email *

*Details of person you are referring, who you wish to receive the 10% discount

First and Last Name *

Email *

Relationship Type *

Please briefly explain how you, and the individual you are referring, will be working together to implement the Melillo Method:

By submitting this form, I, the "Referer"

*Please enter your first and last name (NOT the name of the person you are referring)

confirm that:

The individual named as the "Referee" is actively involved in supporting or delivering services with myself, the "Referer".
I understand this discounted access is only transferable to the individual named on this form as the 'Referee' and is not for resale.
I agree that the course materials will only be used by the individual named as the 'Referee' in collaboration with myself, the "Referer".
By submitting this form, you agree to receive text messages and phone calls from Connected Kidz, which may include automated, pre-recorded, or AI-assisted voice calls. These communications may contain updates, information, and marketing about our programs and services.
You can opt out of future messages at any time by replying “STOP” to a text message or emailing [email protected].

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