hannah@speechcommunication.com.au

Enrolment Form

Please complete the form below to start the enrolment process.

If you would like to enrol more than one child you will need to complete the form once for each child. 


Child's First and Last Names
Class Location
School Year
Child's Date of BirthFormat: DD / MM / YYYY
/ /
Are you interested in AMEB exam enrolment? (Year 4 - 12's only)
 
Parent / Guardian First and Last Names
Parent / Guardian Phone NumberPlease include a number that can be contacted easily in case of emergency.
Parent / Guardian E-mail Address

Medical & Media Consent

Medical Conditions









Medical Condition DetailsIf you have ticked any of the boxes above please provide further information including any action response plan(s).
On occasion, we use lolly snakes and frogs for articulation exercises. If you consent to your child having these please tick yes.
Please add details if Anaphylaxis, gluten-free or any allergies
Media ConsentSpeech and Communication may record sound and/or vision of a student and their work while they are in classes or taking part in school related activities or performances. Photographs of students involved in activities are often published to enable the students to share their experiences and to enable parents and others to be informed about Speech and Communication or activities available at the school. Do you consent to your child being featured in any promotional photographs or videos? Our policy is to only use first names if and when we publish photos including on social media pages.
Media Consent DetailsAre there any comments relating to the above? Please note we ONLY use first names in communication however please add any other information I.e no name / photos only to be used in newsletters etc.
Tuition Comments or Questions or any Previous Experience or Concerns 

THANK YOU

Privacy policy - Information disclosed on this form is only intended for use by Speech and Communication Tuition staff to ensure the health, protection, and safety of every child enrolled. Information on this form is not distributed to a third party and kept private and confidential.