JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
APPLICATION FORM:
The best results are obtained when the following number of lessons are attended:
Grade 8 - 9 learners:
* 1 lesson/week
Grade 10 - 12 learners:
* 2 lessons/week (depending current marks)
* Indicates required question
Email
*
Record my email address with my response
LEARNER - name and surname:
*
Your answer
LEARNER - email address:
*
Your answer
LEARNER - phone number:
*
Your answer
Grade in 2024:
*
Choose
gr.8
gr.9
gr.10
gr.11
gr.12
School:
*
Choose
Hermanus High School
CURRO Hermanus
Overberg High School
Northcliff House
Generations
Quayiya Secondary School
Home School
Hawston Secondary School
Other
Current Mathematics mark:
*
Choose
20% - 30%
40% - 50%
50% - 60%
60% - 70%
70% - 80%
80% - 90%
90% - 100%
PREFERENCE OF DAYS AND TIMES:
* Gr.8 - 9 learners: 1 x lessons / week
* Gr.10 - 12 learners: 2 x lessons / week (depending on current marks)
Monday
Tuesday
Wednesday
Thursday
Friday
14h30 - 15h30
15h30 - 16h30
16h30 - 17h30
17h30 - 18h30
Monday
Tuesday
Wednesday
Thursday
Friday
14h30 - 15h30
15h30 - 16h30
16h30 - 17h30
17h30 - 18h30
PERSON RESPONSIBLE FOR PAYMENT -
Name and surname:
*
Your answer
Phone number:
*
Your answer
Billing address:
*
Your answer
Email address:
*
Your answer
I (PERSON RESPONSIBLE FOR THE ACCOUNT) HEREBY AGREE TO THE FOLLOWING CONDITIONS.
*
I undertake to adhere to THE CLASSROOM's policy that eight lessons for seniors and four lessons for juniors at a time are strictly PREPAYABLE.
I undertake not to accumulate any overdue payments.
I undertake to notify the center one day in advance if a lesson cannot be attended. If a lesson is forfeited without the necessary notice, it will be considered as a completed lesson.
I give permission that my child maybe contacted by Mrs. De Kock.
Other:
Required
Send me a copy of my responses.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
