One-on-One Literacy Tutoring Registration Form Full Child's Name* First Last Date of Birth* Place Of Birth*Residential Address*School Attending*Class*Email Address* Telephone Number*Father's Name*Email Address* Telephone Number*Mother's Name*Email Address* Telephone Number*What subject?*LiteracyNumeracy/MathWhat would you like us to focus on in the subject selected?*How many days of the week would you like your child to be engaged?*How many hours a day?*What are your preferred days for engagement? (Note we will check our schedule to confirm these days are available.)*What specific hour between 4-6pm would you prefer on your preferred days?*Payment Reference Number*Upload Evidence of Payment*Your Passport Photo*GDPR Accepted On* I agree with storage, handling and use of my data and media by this Jordan Hill Creative Writing & Reading Workshop. NameThis field is for validation purposes and should be left unchanged.
