Organisation Name *

Campus (if applicable)

First Name *

Last Name *

Email *

Phone *

Secondary Contact Name *

Secondary Contact Email *

Term

Term 1

Term 2

Term 3

Term 4

If booking for multiple terms please provide details below

What are your school recess and lunch times? *

Who will be responsible for funding the program? *

Is there parking available? If not where will the tutor park? (Please keep in mind our tutors carry equipment and have a dog) *

Is there anything else we need to know? *

Have you booked a chat with Sarah or Louise to discuss the package. After submitting this form please book a chat at a time that suits you. *

Yes

No

Previous Client - Don't need to

How did you hear about us? *