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    Student Last Name (required)

    First Name/ Given Name (required)

    Sex

    MaleFemale

    Birth Date

    School

    How did you find us?

    Would you like to know more about our STEM Programs

    YesNo

    Select School Year

    KindyYear 1Year 2Year 3Year 4Year 5Year 6Year 7Year 8Year 9Year 10Year 11Year 12

    Structure

    GroupOne to One at your home.

    Subject

    Preferred Day

    Preferred Time

    Parent First Name

    Parent Last Name

    Email

    Address

    State

    Postcode

    Telephone Number

    Mobile Number

    Has Student had tutoring before ?

    If Yes, Name of Coaching Center

    Is there a Medical Alert for the Student?

    If Yes, Please specify Medical Condition

    Special Needs

    Does your Child have ?

    AutismBehaviour DisorderHearing impairmentIntellectual disabilityLanguage DisorderMental Health IssuesADD/ADHCVision ImpairmentOther (please specify)

    Has your child ever seen

    Behavioural optometristAudiologistSpeech pathologistEducational psychologistpaediatricianoccupational therapistpsychologistVision ImpairmentOther Specialist (Please specify)

    Primary Family Emergency Contacts

    Name Relationship Telephone Contact Language Spoken
    (Neighbour,Relative,Friend or Other) (If English Write "E")

    Provide Detailed Information About The Challenges Faced By Your Child


    TERMS AND CONDITIONS


    Attendance

    Students are expected to attend all their weekly tutorial classes during the scheduled time and day in which they have been enrolled in. The minimum enrolment period is ONE complete term and Disenrollment cannot be made during this period, nor will refunds be given under ANY circumstance.


    Refund Policy / Outstanding payments

    No credits or refunds will be provided under any circumstances.


    Commitment

    Upon the student enrolling and receiving our invoice, you are required to make full payment for one complete academic term before the first week of that term.


    Absenteeism

    24 hours’ notice must be given prior to cancellation. Make up lessons will be organised during that week. Classes will not be carried onto the next term.


    Termination of tutoring

    After families have left Sprouts Academy, we will occasionally reach out to families to let them know of tips or ideas to help them in the long-term, or to offer them their place back after they have left for a while in case, they need it.


    Code of Conduct

    In an event where the parent/client engages with any of Sprouts Academy’s teacher directly/indirectly, without Sprouts Academy’s written consent, Sprouts Academy has the right to prosecute to the full extent of the law for any damages and losses.


    External Examination Results

    Sprouts Academy requests its students, to provide school examination and assessment results, achievement certificate, HSC results and photographs by phone and email.


    Photography & Videos
    • Sprouts Academy may take photos or videos of students whilst tutoring for promotional, reporting and communication purposes.

    • Occasionally we will share group photos, individual student photos or videos on our social media and other advertising platform.


    Personal Information

    All personal details are kept confidential, changes to such information must be provided as soon as possible. Inaccurate or incomplete information being provided intentionally may result in the non-acceptance of an enrolment or cancellation of an existing enrolment.


    Declaration

    I hereby, declare that all the information provided to Sprouts Academy in this application is true and correct. I understand that the purposeful giving of false, misleading or incomplete information may lead to the refusal of acceptance or cancellation of enrolment. I understand the fees and their structure as explained to me. I understand the cancellation and absenteeism policy. I agree to abide by Sprouts Academy rules and regulations.


    Consent

    You agree that you have read and understood all the terms of agreement.Yes


    Date

    Signature

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