UPLOAD A BOOKLIST

FREE GLUE - $120 VOUCHER FOR ALL FAMILIES - FREE GLUE $5 Picking and Packing Fee

Pay Later options

BOOKLIST UPLOAD AND DETAILS

NAME OF CHILD 1 *

YEAR LEVEL

Gender

CHILD 1 BOOKLIST UPLOAD - Attach school list here *

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PAGE 2 - if required

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NAME OF CHILD 2

YEAR LEVEL CHILD 2

Gender:

CHILD 2 BOOK LIST UPLOAD - Attach school list here

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NAME OF CHILD 3

YEAR LEVEL CHILD 3

Gender;

CHILD 3 BOOK LIST UPLOAD - Attach school list here

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CONTACT DETAILS

PARENT NAME *

MOBILE ( Number to receive order alerts on ) *

EMAIL *

PREFERRED PICK UP LOCATION: *

Port Kennedy FREE Pick up Subiaco - FREE Pick upDelivery $8.95 - Use address above

ADDRESS ( use if delivery is selected )

EXTRA DETAILS

Learning Pod Group can assist in providing customized education plans and a range of school holiday activities, would you like to be kept up to date or contacted regarding:

One to One / Group tutoring:Educational Assessment: Science or Toddler birthday parties:School holiday activities, after school activities, home classes:Education for children with Autism, Dyslexia, ADHD or other:NDIS Capacity building Classes, Plan Management, Products or other:Parenting information sessions and workshops

Additional information - Would you like us to contact you?

YES PLEASE CONTACT ME

Tutoring Education AssessmentsParties Other

HOW WOULD YOU DESCRIBE YOUR CHILD'S LEARNING STYLE?

Easily Distracted Mostly Focused Highly Focused Unsure

COMMENTS/ DIAGNOSIS/ CONDITION ( eg. Sensory, Behaviour,, Possible / Diagnosed / Suspected Conditions - Dyslexia, ADHD Autism, OTHER )

NOTE: Should you require any information in the mean time, please reach out to us.

PAYMENT DETAILS

PAYMENT OPTION *

CALL ME TO CONFIRM DETAILS AND PROCESS PAYMENT OVER THE PHONE - BEFORE ORDER IS STARTEDPROCESS MY ORDER - I WILL PAY ON PICK UP ( ENSURE YOU LEAVE CARD DETAILS BELOW FOR A $20 DEPOSIT ) PROCESS WITH CARD DETAILS BELOW

Card Details: Name, number, Exp, CVC required

HOW DID YOU HEAR ABOUT US? *

CONFIRMATION

I acknowledge by sumitting my list a Learning Pod Group team member will be incontact with an update of my order, I will be provided with quality products some of which some maybe substitute brands to the list provided and FREE GLUE along with a $120 Voucher to spend on a range of Learning Pod Groups popular items and services.

*

By signing this form, I acknowledge the Terms and Conditions of Learning Pod Group and agree all the information is true, correct and understood. *

I allow Learning Pod Group to contact me to process my order further and a $5 Picking and Packing fee applies per list *

Comments:

Signature of parent / guardian

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