The Learning Launchpad Expression of Interest Form
Parent/Guardian Full Name
First Name
Last Name
Parent/Guardian Phone Number
-
Area Code
Phone Number
Parent/Guardian Email Address
example@example.com
Child’s Name
First Name
Last Name
Child’s Age
Please Select
4
5
6
7
What year level is your child currently in?
Please Select
Kindy
Prep
Year 1
What are you hoping your child will gain from these sessions?
Confidence building
Emotional regulation
Social skills
School readiness
Independence
Early literacy and numeracy support
Fine motor skills
What type of session would interest you most?
Little Launchers (Kindy)
Rocket Ready (Prep)
Orbit Explorers (Year 1)
What day would suit you best?
Monday
Tuesday
Wednesday
Preferred session times:
Morning
Midday
Afterschool
Would you like to be contacted when bookings open?
Yes
No
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