Language Champs: Enrollments

Melbourne Australia
50 Station Street, Moorabbin, VIC
Phone (03) 9555 5355
Email: info@languagechamps.com.au
Box Hill, Moorabbin, City, Other Suburbs

Enrollment Form

* Fields must be filled in.

Personal Details

Firstname

Surname

If Child (tick if applicable)

Mailing Address

Street

Postcode

Suburb

State

Contact Details

Phone

Mobile

Date of Birth

Class Details

Language

Day

Time

Level

Guardian Details

Guardian Firstname

Guardian Surname

Guardian Street

Guardian State

Guardian Suburb

Guardian Postcode

Guardian Phone

Guardian Mobile

Emergency Contact Details

Emergency Contact Firstname

Emergency Contact Surname

Emergency Contact Phone

Emergency Contact Mobile

Medical Conditions

Person Picking Up Details

If the person picking up your child is not one of their guardians, please fill in this section

Person Picking Up 1

Person Picking Up 2

International Students Program

Staff Application

Translation Service