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Registration Form
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Name of School
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2
Category
Pre- Primary Level
Primary Level
Both
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3
Grades
Baby Class
Middle Class
Pre-Unit
Std 1
Std 2
Std 3
Std 4
Std 5
Std 6
Std 7
Std 8
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4
School Information
Region
District
Physical Address of School
Telephone
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5
School Management
Name of Principal / Headmaster/ Headmistress
Telephone
Email
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6
Name(s) of the Reader's Club Champion / Coach / Volunteer with the Grade they supervise
Kindly Attach the Contract Form for Each Volunteer
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7
Reading Club Details
Average Age of Leaners per Grade
Number of Boys
Number of Girls
English
Kiswahili
French
Spanish
Chinese
Others
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English
Kiswahili
French
Spanish
Chinese
Others
Languages in which the Books are Read
Please Select
English
Kiswahili
French
Spanish
Chinese
Others
Please Select
Please Select
English
Kiswahili
French
Spanish
Chinese
Others
Language frequently used for Communication in the Club
How many Learners are in the Club on a Regular basis
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8
Fill If the Reading Club is supported by another Organisation apart from Longhorn Publishers
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Name of Organisation
Address of Organisation
Focused area of Support
Telephone
Email
Date of Registration with the Organisation
Expiration of Support
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9
Profile of the Regular Leader of the Reading Club
Teacher
Parent/Care Giver
NGO Practitioner
OlderChild
Other
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10
Frequency of Meetings
When does the Reading Club meet?
Before School
During School
After School
Other
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11
How often does the Reading Club meet?
5 times a Week
2-3 times a Week
Once a Week
Every 2 Weeks
Once a Month
Other
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12
Has permission been obtained from each parent for the learner to take part in the reading club and to take photographs and use them for educational purposes?
Yes
No
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13
For any Recommendations / Enquires
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14
Download Volunteer Contract
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15
Upload Volunteer Contract
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Signature
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