HSC CoWorks - Trial Enrolment Question Title * 1. HSC year HSC 2020 HSC 2021 Question Title * 2. Parent 1 Details First Name / Last Name * Address * Address 2 Suburb * Postcode * Email Address * Phone Number * Question Title * 3. Student Details First Name / Last Name Email Address Phone Number Question Title * 4. Student's Date of Birth D.O.B Date Question Title * 5. Student's School Question Title * 6. Student's Subjects Question Title * 7. Do you now, or have you ever had, another child on the HSC CoWorks Programme? Note name below. Question Title * 8. Preferred Trial Session (Weekday) DEE WHY: Tuesday 4-6pm DEE WHY: Tuesday 6:15-8:15pm DEE WHY: Wednesday 4-6pm BONDI JUNCTION: Monday 4-6pm BONDI JUNCTION: Tuesday 4-6pm BONDI JUNCTION: Wednesday 4-6pm MOSMAN: Tuesday 4-6pm Question Title * 9. Does your child have any specific learning difficulties that you think we should be aware of? Question Title * 10. Does your child have any medical conditions we need to be aware of? If yes, please describe the condition and attach a Medical Action Plan (in Q15) as prescribed by the doctor (if applicable). Please note that for health and safety reasons, HSC CoWorks reserves its rights to decline your child’s enrolment if we are of the view that our staff members are unable to administer your child’s Medical Action Plan. Yes No Comments Question Title * 11. Please attach Medical Action Plan If required as per Q14 DOCX, DOC, JPEG, GIF, JPG, PDF, PNG file types only. Choose File Choose File No file chosen Remove File If required as per Q14 Done