Inspired Minds Solutions l Enrolment Form

First name

Last name

Phone

Address (Street number, Street name, Suburb, State, Country, Postcode)

Payment Options

Weekly Direct Debit from Nominated Bank Account

Term upfront

CHILD ONE name and date of birth

Does your child attend mainstream education or home school?

Mainstream

Homeschool

Does your child attend mainstream education or home school?

Please give details of their current ENGLISH needs

Please give details of their current MATHS needs

Please give details of their current SOCIAL/EMOTIONAL needs

Please give details of their current hobbies and interests

Please give more details here of anything that you feel is relevant to CHILD 1's needs and goals.

CHILD TWO name and date of birth

Does your child attend mainstream education or home school?

Mainstream

Homeschool

Please give details of their current ENGLISH needs

Please give details of their current MATHS needs

Please give details of their current SOCIAL/EMOTIONAL needs

Please give details of their current hobbies and interests

Please give more details here of anything that you feel is relevant to CHILD 2's needs and goals.

By checking the boxes below, you:

Have read and agree to the terms and conditions of enrolment (available on the website)

Give permission for your child's images being used for social media and/or advertising.

Have read and agree to the payment and cancellation policy within the terms and conditions.