Theorix Academy Enrolment Form

Theorix Academy Enrolment Form

Australia's Online Mathematics Academy
Student Details
Name

First NameLast Name
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit year
School
Year Level
Preliminary Course
HSC Course
Email
example@example.com
Phone Number

Area CodePhone Number
Parent Details
Name

First NameLast Name
Email
example@example.com
Phone Number

Area CodePhone Number
Learning Profile
Rate your child's enjoyment of mathematics at school

1

2

3

4

5

1 is Not at all, 5 is Best subject
What was your child's most recent mathematics exam score (%) at school?
Does your child have any learning considerations we should be aware of?
Anything else you'd like us to know about your child?
Availability
Availability for Class
What is your preferred lesson starting time on Monday?

Hour Minutes

AM/PM Option
What is your preferred lesson starting time on Tuesday?

Hour Minutes

AM/PM Option
What is your preferred lesson starting time on Wednesday?

Hour Minutes

AM/PM Option
What is your preferred lesson starting time on Thursday?

Hour Minutes

AM/PM Option
What is your preferred lesson starting time on Friday?

Hour Minutes

AM/PM Option
What is your preferred lesson starting time on Saturday?

Hour Minutes

AM/PM Option
What is your preferred lesson starting time on Sunday?

Hour Minutes

AM/PM Option
Consent
Signature
Please verify that you are human
How did you hear about Theorix Academy?
Should be Empty:

Student Details