Enter as much information as you can for each child you intend to register (one per child).
The form must be completed by a Parent or Guardian unless the student is at least 18 years of age, and the
Parent or Guardian must agree to the Terms and Conditions of Enrolment.

Campus *

Tick all that apply

Derrimut

Williams Landing

Caroline Springs

Online

Parent/Guardian Details

Name of person completing this form: *

First Name

Last Name

Email Address *

Home Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Mobile *

Student Details

Name *

First Name

Last Name

Gender *

Male

Female

Year Level *

Please state the subjects the student would like help with: *

Health Conditions

Please indicate if the student has any health issues, allergies, or anything we might need to be aware of.

Actions to take

If the student suffers from any of the above conditions, what would you like us to do? E.g. Call a specific person. (Note that we are not trained to deal with medical situations. If the situation is an emergency we will always call 000 and try to contact you immediately).

Tutor Preference

Please indicate if there is a specific tutor that you or the students know that they would like to be taught by.

Day and Time Preferences

Monday

4.30pm to 6.30pm

6.30pm to 8.30pm

Tuesday

4.30pm to 6.30pm

6.30pm to 8.30pm

Wednesday

4.30pm to 6.30pm

6.30pm to 8.30pm

Thursday

4.30pm to 6.30pm

6.30pm to 8.30pm

Friday

4.30pm to 6.30pm

6.30pm to 8.30pm

Saturday

9.00am to 11.00am

11.00am to 1.00pm

1.00pm to 3.00pm

3.00pm to 5.00pm

Sunday

9.00am to 11.00am

11.00am to 1.00pm

1.00pm to 3.00pm

3.00pm to 5.00pm

Additional Information

Is there anything else you'd like to tell us?

Do you agree with Five Tuition's 'Terms and Conditions' (See link below)? *

Yes, I Agree with the Terms and Conditions of enrolment.

How did you hear about Five Tuition?

Thanks for enrolling! We'll be in touch soon. If you have other children you need to enrol, please go back to the enrolment form and complete it again for the next child.

Terms and Conditions

Five Tuition, 1-11 Elgar Road, Derrimut, VIC, 3030, Australia+61 477 690 323hello@fivetuition.com.au

Contact Us

Name *

First Name

Last Name

Campus

Email Address *

Contact Number

Message *

Thank you!

Please leave us a message and we’ll get back to you within 24 hours.

Five Tuition respects and honours Aboriginal and Torres Strait Islander Elders past, present and future. We acknowledge the stories, traditions and living cultures of Aboriginal and Torres Strait Islander peoples on this land and commit to building a brighter future together.