Registration form - Rolling Strike Days Term 2, 2023

Registration form - Rolling Strike Days Term 2, 2023

Registration form Strike Day Supervision
This form is to register any student who is unable to be supervised at home when Rutherford College teachers are at the Paid Union Meeting.

Please note that during this time, students will be supervised only, they will not be formally learning.

Thank you

Rutherford College Administration
Student's Name*

First NameLast Name
Year level*
27 June: PUM
Parent/ Caregiver's name*

First NameLast Name
Parent/ Caregiver's address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Parent/ Caregiver's email*
example@example.com
Parent/ Caregiver's Phone Number*

Area CodePhone Number
What is your relationship to the student?*
Is there anything else we need to know?
Should be Empty: