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    1. Details

    *Student Given Name
    *Student Family Name
    *Student Number (ID)
    *Student Birthday
    *Contact Number
    *Email Address
    *Subject 1
    Subject 2
    Subject 3
    Subject 4

    2. Feedback

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    Content too difficultContent too easyCould not understand teacher's explanationCannot balance with school/other commitmentsOther (Please specify below)
    Any Additional Feedback (Optional)

    3. Bank Details

    *Account Name
    *BSB
    *Account Number

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