Petjuan Saturday Class

Student Registration

Taught by Peta-Gay Williams, an educator with 10 years of experience. Reading is offered for ages 5–15, with science classes for Grades 9–11.

This form collects student and guardian information for class registration and attendance administration. Details are available only to authorized Petjuan administrators.

Academic details

Select the school year and current grade.

Academic year *Registration date *Grade level *

Student information

Enter the student’s legal and contact details.

Full legal name *Date of birth *Student ID (optional)Sex *Home address *City / parish / postal code *

Learning format

Choose how the student will attend.

Face-to-faceOnline via Google MeetGoogle Classroom

Subjects

Reading is for ages 5–15. Science subjects are for Grades 9–11.

Learning support

This helps the teacher prepare appropriate support.

Has a learning disability been diagnosed?

NoYes

Parent or guardian

Guardian 1 is required. Guardian 2 is optional.

Guardian 1 full name *Relationship *Home address *City / parish / postal code *Phone *Email *

Guardian 2 (optional)

Guardian 2 full nameRelationshipHome addressCity / parish / postal codePhoneEmail

Emergency contact

Emergency contact name *Emergency contact phone *

Class payment

Confirm the class fee with Petjuan before making a transfer.

Payment is kept separate from shipping invoices. A bank transfer remains pending until Petjuan staff reviews the reference and proof.

Loading payment details...

Payment status for this registration

Pay later / contact PetjuanI already made a bank transfer

Declaration

Typing a name below acts as an electronic signature.

Guardian signature (full name) *Guardian signature date *Student signature (full name) *Student signature date *I confirm that this information is accurate and authorize Petjuan Saturday Class to use it for registration, learning support, communication and attendance administration.

After submission, keep the registration reference shown on screen.