Student Name *

First Name

Last Name

Parent (or Guardian) Name *

First Name

Last Name

Parent (or Guardian) Phone No. *

This will only be used for communicating with our tutor in relation to the tuition course

(###)

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Which year is the student in *

Year 10

Year 11

Which Exam Board do you study *

Edexcel

AQA

OCR

I'm not sure

Which Tier do you study *

Higher

Foundation

What can we help you with *

This will help us understand your goal

Improve Grade

Prepare for Exams

Catch up with your class

Get ahead of your class

Which day(s) work for you *

This will help us understand which days are most convenient for student to have 1-to-1 tuition.

Monday

Tuesday

Wednesday

Thursday

Friday

Saturday

Sunday

Which time(s) work for you *

This will help us understand which days are most convenient for student to have 1-to-1 tuition.

Morning (8am - 12pm)

Afternoon (12pm - 4pm)

Evening (4pm - 8pm)

Do you plan to do A-level Math *

This will help us understand which days are most convenient for student to have 1-to-1 tuition.

Yes

No

I don't know