Date today
-
Day
-
Month
Year
Date
Department
Campaign
Location
Lead Source
Sales Stage
Admin Notes
Attention: Please check if customer has a contract in links first before contacting. Admin
SALT Location
Please Select
NSW-Bankstown
NSW-Casula
NSW-Chatswood
NSW-Prospect
NSW-Sylvania
NSW-St Leonards
NSW-Top Ryde
NSW-Willoughby
QLD-Carindale
QLD-Lutwyche
SA-Royal Park
SA-Payneham
SA-Salisbury
VIC-Hoppers Crossing
VIC-Bacchus Marsh
VIC-Bayside
VIC-Botanic Ridge
VIC-Craigieburn
VIC-Mill Park
VIC-Laverton
VIC-South Morang
VIC-Sandringham
WA-Lakelands
WA-Cannington
Your Location
*
Please Select
NSW-Bankstown
NSW-Casula
NSW-Chatswood
NSW-Prospect
NSW-Sylvania
NSW-St Leonards
NSW-Top Ryde
NSW-Willoughby
SA-Royal Park
SA-Payneham
SA-Salisbury
QLD-Carindale
QLD-Lutwyche
VIC-Hoppers Crossing
VIC-Bacchus Marsh
VIC-Bayside
VIC-Botanic Ridge
VIC-Craigieburn
VIC-Laverton
VIC-Mill Park
VIC-South Morang
VIC-Sandringham
WA-Lakelands
WA-Cannington
Name
*
First Name
Last Name
Email
*
example@example.com.au
Mobile Number
*
Please enter a valid phone number.
Format: 0000000000.
Student Details
Student First Name
*
Gender
*
Please Select
Male
Female
Other
I prefer not to say
Did {child_name} previously swim at Swim First?
*
Yes
No
Did {child_name} previously swim at Good Life?
*
Yes
No
What is the current / last level they were enrolled in at Swim First?
*
Please Select
Aquatots (12-24months)
Aquatots (23-36months)
Level 1
Level 1 / Level 2
Level 1 / Level 2 (School age)
Level 2 (School age)
Level 3
Level 4
Level 5
Level 6
Level 7
Level 8
Squad
What is the current / last level they were enrolled in at Good Life?
*
Please Select
Little Ducklings (4-12 Months)
Little Ducklings (12-24 Months)
Little Ducklings (24-36 Months)
Tadpoles / Frogs
Tadpoles / Frogs (advanced)
Penguins
Tadpoles / Frogs (School age)
Penguins (School Age)
Turtle
Otters
Seahorse
Shark
Shark (advanced)
Student Date of Birth
*
-
Day
-
Month
Year
Date
Child Age
Child Age Calculation
As of next year, has {child_name} started Primary School?
*
Yes
No
Has {child_name} had any swimming lessons previously?
*
Yes
No
Has {child_name} had any swimming lessons previously?
*
Yes
No
Has {child_name} had any swimming lessons previously?
*
Yes
No
Can {child_name} swim independently - no flotation aids?
*
Yes
No
Can {child_name} swim 50m of all 4 strokes; freestyle, backstroke, breaststroke, butterfly and perform a tumble turn?
*
Yes
No
Can {child_name} swim breaststroke?
*
Yes
No
Can {child_name} swim 12m of freestyle and backstroke, perform a basic breaststroke and butterfly kick?
*
Yes
No
Can {child_name} perform a basic breaststroke kick?
*
Yes
No
Can {child_name} swim 12m freestyle with a basic breathing pattern?
*
Yes
No
Can {child_name} swim independently and are they able to perform basic freestyle?
*
Yes
No
Is {child_name} confident and able to swim independently?
*
Yes
No
Can {child_name} swim freestyle with a basic breathing pattern and backstroke?
*
Yes
No
Can {child_name} confidently swim freestyle and backstroke, basic breaststroke and butterfly kick?
*
Yes
No
Is {child_name} confident and able to swim independently?
*
Yes
No
Can {child_name} swim freestyle with a basic breathing pattern and basic backstroke?
Yes
No
Comment
AC Location
Your Level - Aquatots
Your Level - Squid
Your Level - Waterplay
Your Level - Starfish
Your Level - Clownfish
Your Level - Penguin
Your Level - Seahorse
Your Level - Stingray
Your Level - Angelfish
Your Level - Jellyfish
Your Level - Platypus
Your Level - Dolphin
Your Level - Shark
Your Level - Croc
Your Level - SwimFit
Your Level - Squads
Your Level - Adolescent Beginner
Your Level - Adolescent Intermediate
Your Level - Adolescent Advanced
Your Level - Adult Beginner
Your Level - Adult Intermediate
iClass Locatons
Please Select
NSW-Bankstown
NSW-Casula
NSW-Chatswood
NSW-Dee Why
NSW-Prospect
NSW-Sylvania
NSW-St Leonards
NSW-Top Ryde
NSW-Willoughby
QLD-Carindale
QLD-Lutwyche
SA-Royal Park
SA-Payneham
SA-Salisbury
VIC-Hoppers Crossing
VIC-Bacchus Marsh
VIC-Bayside
VIC-Botanic Ridge
VIC-Craigieburn
VIC-Mill Park
VIC-Laverton
VIC-South Morang
VIC-Sandringham
WA-Lakelands
WA-Cannington
iClass Location code
utm_source
utm_medium
utm_campaign
utm_content
utm_term
device
placement
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