Enrolment

Please provide as much information and detail as possible as it will assist our team in supporting your child. Required responses are indicated by green border on the inputs.

I am enrolling my child in

School ReadinessK-2 Literacy GroupOne-on-One Tutoring

For which term?

Term 1Term 2Term 3Term 4

Child's details

Child's nameChild's preferred nameChild's date of birthChild's day care/pre-school/school:

Areas of concernWhat are your child's interests? (outside of day care/pre-school/school)What are your child's strengths?What are your child's weaknesses?Does your child have any learning difficulties we should be aware of?What are you hoping to get out of this program?

Medical Information

Does your child have any medical issues or concerns we need to be aware of (including allergies)?

YesNo

Referral Information

YesNo

Contact Details

Parent/guardian's nameHome addressMobile numberEmail addressHome numberPlace of workWork number

Contact 2

Parent/guardian's nameHome addressMobile numberEmail addressHome numberPlace of workWork number

Would you be okay with us taking photos and videos during our sessions to share on our website and social media pages? We love capturing the fun and excitement of our sessions and would love to showcase your child's progress.

YesYes

Additional comments

Please let us know if there's anything else you'd like to know (or let us know)How did you hear about us?