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PLEASE NOTE MOST OF OUR SESSIONS ARE IN-PERSON AT FINSBURY PARK, LONDON
Parent First Name
Parent Last Name
Parent Email
Mobile Phone
Address
City
Post Code
Do you (and your partner, if you have one) work and claim Universal Credit? (If so, you may be able to claim back up to 85% of your session fees)
Yes - single parent and working
Yes - couple and both working
Yes - couple and one works (partner unable to work due to illness or disability or caring)
On UC but not working / partner not working
No - not claiming UC
How did hear about us?
Emergency contact: if we can't reach you during a session, who should we call? Please give their full name and their relationship to your child (e.g. aunt, grandparent, family friend). This must be someone other than you.
Emergency contact's phone number (the person named above). Please give a mobile number they usually answer.
Student information
Student
First Name
Last Name
Date of Birth
Year Group
Subjects you are interested in enrolling for
A-Level Biology
A-Level Chemistry
A-Level English
A-Level Mathematics
A-Level Physics
Functional Skills/Entry Level/ESOL
GCSE Biology
GCSE Chemistry
GCSE English
GCSE Mathematics
GCSE Physics
KS2 English
KS2 Mathematics
KS3 English
KS3 Mathematics
KS3 Science
What is your preferred session type?
Select
1.2.1s
group sessions
both
not sure yet
School
Which days can your child attend? (tick all that apply)
Monday
Tuesday
Wednesday
Thursday
Saturday
Sunday
What times work for the days you selected? (tick all that apply)
Weekday after school 4:45–6:45pm
Weekday evening 7–9pm
Weekend morning 9:45am–2pm
Weekend afternoon 2:15–6:30pm
Does your child have any additional needs we should know about? This includes any special educational needs or disabilities (e.g. dyslexia, ADHD, autism, EHCP), medical conditions, allergies, medication they may need during sessions. Please write "None" if not applicable.
How will your child get home after sessions?
Travels home on their own
Always collected by me (parent or carer)
Collected by me or another adult listed below
Sometimes on their own and sometimes collected.
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