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Hampshire Achieves Family Learning Course Enrolment Form 2020/21
Boogie Mites School Ready/Minis/Teenies/Babies/SEN Courses
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* Indicates required question
Email
*
Your email
Title
*
Miss
Ms
Mrs
Mr
Other:
Surname
*
Your answer
First Name
*
Your answer
Previous surname (if applicable)
Your answer
Are you?
*
Male
Female
Your Date of Birth
*
MM
/
DD
/
YYYY
Child's First Name
*
Your answer
Child's Date of Birth
*
MM
/
DD
/
YYYY
Is your child?
*
Male
Female
Home address - Street 1
*
Your answer
Home address - Street 2
Your answer
Home address - City
*
Your answer
Home address - County
*
Your answer
Home address - Postcode
*
Your answer
Previous postcode (if changed within the last 3 years)
Your answer
Mobile Phone Number
*
Your answer
Home Phone Number
Your answer
Work Phone Number
Your answer
Have you attended any other course in the last 3 years?
*
Yes
No
Are you a UK national or a person with right of abode in the UK and have been ordinarily resident in the UK for at least three years at the start of this course?
*
Yes
No
From the options below, please tick the box you feel best describes your ethnic origin:
*
White - English/Welsh/Scottish/Northern Irish/British
White - Irish
White - Gipsy or Irish Traveller
White - any other white background
Mixed - White and Black Caribbean
Mixed - White and Black African
Mixed - White and Asian
Mixed - any other multiple ethnic background
Asian - Indian
Asian - Pakistani
Asian - Bangladeshi
Asian - Chinese
Asian - any other Asian background
Black - African
Black - Caribbean
Black - any other Black/African/Caribbean background
Other - Arab
Other - any other ethnic group
I prefer not to say
How confident do you feel about filling in forms? (If necessary, your tutor can help you to complete the forms that are part of this course).
*
Very confident
Okay
Not very confident
What are your reason(s) for joining the course (tick as many as apply).
*
1. To learn how music can support my child's development
2. To bond with my child through this shared experience
3. To link with other parents with children of a similar age
4. To obtain resources and knowledge to continue home practise
5. To start a learning journey for myself and find out what other courses are available to me
Other:
Required
Which course have you enrolled on?
*
Choose
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