Enrolment Form 2021

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Enrolment Form 2021

Adresse e-mail *

Child's Name (First) *

Child's Name (Last) *

School *

Age of child in September *

I will be paying for the following course *

Thursday @ 5.30pm

Year 6-7 (Tuesdays @ 5.40pm)

Year 8-9 (Tuesdays @ 6.40pm)

My child cannot attend at these times.

If you cannot attend the times above, please suggest another time you would be able to participate.

Sunday morning

Monday evening

Wednesday evening

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Address of named child *

Name of parent / carer *

Email of parent / carer *

Phone number of parent / carer *

Child's level of English for their age *

Below average

Average

Above average

Does the named child have any medical conditions / additional needs / requirements? *

Yes

If yes, please specify:

Parental consent *

I give permission for my child to enrol on to the Young Black Leaders Course

Une copie de vos réponses sera envoyée par e-mail à l'adresse indiquée.

Envoyer

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