Enrolment Form - Simplify Education

Simplify Education Enrolment Form

Student Name *

First

Last

Date of Birth *

DD/MM/YYYY

Gender (M/F) *

Male or Female

School Name *

School Name

Grade / Years *

Grade / Years

Parent / Guardian Name *

Parent / Guardian Name

Mobile *

Mobile Number

Home Phone

Home Phone Number

Email *

Confirm Email

Your contact email

Does the child have any allergies/medical condition(s)? *

Please specify if any medical conditions or any allergies.

Class Enrolled *

Please choose the class that you want to enrol your child.

Do you permit for your child's photo to be used in promotional and marketing purposes for Simplify Education?

You agreed all above information is true and correct. *

Yes or No