Request for assistance

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Please complete this form should you require support for a learner registered at Fields College. All requests will be treated confidentially and every effort will be made to accommodate your request should you meet the criteria and resources be available. If you have more than one child, please complete separate forms.

1.Please type your name and surname. *

2.Please provide a contact number. *

3.Please write the surname and name of the learner. *

4.Please indicate their grade and class. *

5.Please indicate where assistance is required. Tick all that apply. *

Lunch

School uniform

School stationery

Referral to the school counsellor (informal support)

Other:

Required

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