Summer Intensive Teacher Observation Form

TEACHER DETAILS
Teacher's Name *

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Email *
example@example.com
Home phone number

Area Code Phone Number
Mobile phone number *
Where do you teach? *
Teaching Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Studio Phone Number *
Studio Email *
example@example.com
Syllabi taught (if applicable)
e.g. RAD / NCEA
Teacher Observation *
Prices include GST
Please choose which days

Tuesday only $40 Wednesday only $40 Thursday only $40 Friday only $40
PAYMENT

All prices include GST
Total to Pay
IMPORTANT: Make note of the total cost to pay before submitting this form

Applications will not be processed until payment has been received.
Payment Method *

Internet Transfer Visa or Mastercard
Overseas applicants, including Australians, may only pay by Visa or Mastercard
REFUND POLICY
If due to injury or ill-health it is necessary to withdraw from the course the refund policy is as follows: Anyone withdrawing on or before 10 January 2021 will be entitled to a refund of 80% of the course fees upon presentation of a medical certificate. Anyone withdrawing after 10 January 2021 will not be entitled to a refund under any circumstances. *

Please tick to show you have read and understood our refunds policy
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Teacher Observation Form