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Enrolment Form
PARENT First Name
*
PARENT Last Name
*
Email
*
Phone
*
Address
City
State
Post Code
STUDENT #1 First Name
*
STUDENT #1 Last Name
*
STUDENT #1 Address - if different from parent address.
STUDENT #1 Birthday
*
Day
Month
Month
Year
STUDENT #1 School
*
STUDENT #1 Year Level
*
STUDENT #2 First Name
STUDENT #2 Last Name
STUDENT #2 Address - if different from parent address.
Student #2 Birthdate (If more than one student)
Day
Month
Month
Year
STUDENT #2 School
STUDENT #2 Year Level
STUDENT #3 First Name
STUDENT #3 Last Name
STUDENT #3 Address - If different from parent address
Student #3 Birthdate (If more than two students)
Day
Month
Month
Year
STUDENT #3 School
STUDENT #3 Year Level
How can we support your child?
*
Personal One-on-One Tutoring (Face-to-Face)
Personal One-on-One Tutoring (Online)
Focused Small Group Classes
Mentoring
School Readiness Programs
Workshops & Holiday Programs
Allied Health Services
If you are interested in Focused Small Group Classes, please indicate which service you are interested in.
Middle Primary Advanced Mathematics (Year 4 & Year 5)
Upper Primary Advanced Mathematics (Year 5 & Year 6)
Early Secondary Advanced Mathematics (Year 7 & Year 8)
Literacy Enhancement (Year 4 - Year 8)
Tell us about your child and their academic journey?
*
Please indicate if your child has any verified learning needs?
How can we best support you and your child?
*
Submit
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