Tutoring Registration Form - Tutorica Academy

Dear Guardians,

Monthly fees are required to be paid in advance, as stipulated in the Enrolment Agreement.

Please ensure that you have settled the first month's fees before the learner's first class.
If we have not received payment, the learner will not be admitted.
Click here for Tutorica's Banking details >

This contract will remain in effect for the duration of the Learner's enrolment at Tutorica Academy. Fees and packages are subject to change.

IMPAQ student number (if available).

Please upload proof of registration at IMPAQ (if available).

Choose File

Upload image of Learner ID

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Learner Date of Birth (dd/mm/yyyy)

Learner Current Grade

Grade 1

Grade 2

Grade 3

Grade 4

Grade 5

Grade 6

Grade 7

What Grade is the Learner registering for?

Grade 1

Grade 2

Grade 3

Grade 4

Grade 5

Grade 6

Grade 7

Language of Instruction

English

Afrikaans

Guardian Information

Guardian Contact Number

Guardian Email Address

Guardian Identity Number

Relation to Learner (eg: Father, Mother, Grandmother)

Emergency Contact

Please provide details for an emergency contact, in case the Learner's Guardian cannot be reached.

Emergency Contact First Name

Emergency Contact Last Name

Emergency Contact Relation to Learner (eg: Father, Mother, Grandmother)

Emergency Contact Phone/Mobile

Emergency Contact Email

Medical Aid Information

Main Member Full Name

Please list any allergies the learner has:

Doctor Contact Number

Does the learner take chronic medication?

Yes

Name of chronic medication

Name of chronic condition

Please upload a copy of your medical aid card that clearly shows your details

Choose File

How did you learn about Tutorica?

Any additional comments you'd like to add?

As the Guardian of an Enroled Learner at Tutorica Academy, I agree to Tutorica Academy's Code of Conduct, Indemnity Agreement and Enrolment Agreement, which can be accessed here.

I hereby consent that the information that I have provided is accurate, and to have this website store my submitted information, so they can respond to my inquiry.

I consent to have this website store my submitted information, so they can send me newsletters

Home-school Tutoring Registration Form

Learner Details

Guardian Information

Emergency Contact

Medical Aid Information

Home-school Tutoring Registration Form

Learner Details

Guardian Information

Emergency Contact

Medical Aid Information

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