Sign-up Questionnnaire

Your Write to Rachel Programme Sign-Up Questionnaire

INSTRUCTIONS:

Please complete the below short Programme Questionnaire online on you and your child to help us design a personalised programme for your child. Or download the form and send the completed Questionnaire to [email protected].

your_write_to_rachel_programme_form.docx
File Size:	355 kb
File Type:	docx

Download File

your_write_to_rachel_programme_form_.pdf
File Size:	253 kb
File Type:	pdf

Download File

Information about the Parent(s) or other Responsible Person(s)

* Indicates required field

Name *

First

Last

Name *

First

Last

Email *

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Other information: *

To whom should copies of Write to Rachel letters to your child be copied and what are their email and phone contact details:

Name *

First

Last

Phone Number *

Email *

Information about your Child:

Name *

First

Last

Date of Birth:

Day *

Month *

Year *

Names of parents/guardians/responsible persons:

Parent/guardian/responsible person name *

First

Last

Parent/guardian/responsible person name *

First

Last

Parent/guardian/responsible person name *

First

Last

Brothers/sisters names and ages:

Name *

First

Last

Age *

Name *

First

Last

Name *

First

Last

Name *

First

Last

Names and information about other 'important persons' for your child e.g. Grandparents, relatives, best friends, pets, etc.:

Name/Information *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Other places lived: *

School(s) attended: *

Interests/hobbies: *

Likes and dislikes: *

Anything else that it is important for Write to Rachel to know? *

Areas you would like Write to Rachel to develop with your child (please choose as applicable): *

Composition Vocabulary Spelling and Punctuation Other (please describe under 'Anything else important ... box above)

Age *

Submit

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CONTACT
Email: [email protected]
Telephone: +44 (0)7771 922 051
Skype: WritetoRachel
Website: www.WritetoRachel.com

CONTACT US

Your Write to Rachel Programme Sign-Up Questionnaire

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FIND﻿

CONTACTEmail: [email protected]Telephone: +44 (0)7771 922 051Skype: WritetoRachelWebsite: www.WritetoRachel.com

CONTACT US

FIND

CONTACT
Email: [email protected]
Telephone: +44 (0)7771 922 051
Skype: WritetoRachel
Website: www.WritetoRachel.com