Expression of Interest: Creative Writing Club
Thank you for your interest in the Mayfield School Holidays Writing Club Please fill out the form below
Your Full Name
*
First Name
Last Name
Your Child's Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: 0000 000 000.
What time best fits you?
*
10:30AM - 1:00PM
1:30PM - 4:00PM
Happy with either
Will you be able to attend all 3 days?
*
Yes
No
What is your funding?
*
NDIS
Medicare
Private Insurance
Private Fee Paying
What level of reading/writing is your child?
*
What level of support does your child need for toileting?
*
Independent/None
Prompting to go to the bathroom
Physical support
Nappy changing
How does your child communicate? Please include any aids they require if applicable
*
Does your child require medication?
*
Yes
No
What is the medication?
*
Do you require the medication to be administered? If yes, please include the method, times and dosage
*
Are there any behaviours of concern for your child?
*
Yes
No
What are the behaviours of concern?
*
What can we do to support your child?
*
What interests does your child have?
Why are you interested in the creative writing club?
Is there any additional information we need to know about you or your child?
Submit
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