Malvern Playgroup - Expression of Interest Form

Dear Parents,

Thank you for your interest in Malvern Playgroup. Please complete the Expression of Interest Form if you wish to receive information about our Playgroup Programme.

Kindly complete the form in English. Please do not furnish any other information apart from those requested below, or send multiple requests or provide multiple contacts for the same child. We will provide additional information to you via email.

A. PARENTS INFORMATION

Salutation *

Father/Guardian/1st Parent's First Name *

Father/Guardian/1st Parent's Surname *

Salutation

Mother/2nd Parent's First Name

Mother/2nd Parent's Surname

B. CONTACT DETAILS

Primary Contact Person *

Father/1st Parent

Mother/2nd Parent

Legal Guardian

Email Address *

Country Code *

Phone Number *

C. INFORMATION ABOUT YOUR CHILD(REN)

Child 1 Details

First Name *

Last Name *

Gender *

Date of Birth (DD/MM/YYYY) * +

Intended Enrollment Year *

Country of Birth *

Country of Citizenship *

Ethnic Origin *

Child 2 Details

First Name

Last Name

Gender

Date of Birth (DD/MM/YYYY) +

Intended Enrollment Year

Country of Birth

Country of Citizenship

Ethnic Origin

Child 3 Details

First Name

Last Name

Gender

Date of Birth (DD/MM/YYYY) +

Intended Enrollment Year

Country of Birth

Country of Citizenship

Ethnic Origin

D. OLD MALVERNIAN/ALUMNI

Are you or your spouse an Old Malvernian or alumnus of Malvern College family of schools? *

No

Yes

E. HOW DID YOU HEAR ABOUT US?

Source *

Any questions or comments?