Name ____________________ Surname
________________________
Address: Street ______________________ Number
______
Home Phone ______________________ Mobile Phone ____________________
Part 1 – For teachers
Have you ever worked as a teacher?
Yes / No Are you a
qualified teacher? Yes / No
What grades do you prefer to teach? 1st 2nd
3rd 4th 5th 6th
7th 8th 9th 10th 11th 12th
Part 2 – For parents
How many children are you
interested in sending to the
In what grades?: 1st 2nd 3rd 4th 5th 6th 7th 8th 9th 10th 11th 12th
How much are you able to pay per child per month? ________________________
Part 3 – For teachers, parents and others
Are you interested in helping to establish
the school? Yes /
No If so, How?
Joining the Board / Building search / Fundraising / Joining the
Education Committee
Date ____________________ Signature ________________________