JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Leicester Tuition Academy Application
Based at Leicester High School for Girls, 454 London Road, Leicester, LE2 2PP
Sign in to Google
to save your progress.
Learn more
* Indicates required question
I have read the Leicester Tuition Academy terms and conditions
www.LeicesterTuition.com/TandC
*
I agree to the terms and conditions, including a 4 week notice period and payment for missed sessions
Required
How did you hear about us?
*
Your answer
Which subjects would you like to study?
*
Maths
English
Science
11+
Required
Which day(s) would you like your child to attend?
*
Wednesday (Maths, English and Science)
Required
Email Address
*
Your answer
Parents name
*
Your answer
Home telephone number
*
Your answer
Parents mobile number
*
Your answer
Parents 2nd mobile number (optional)
Your answer
Student's Gender
*
Male
Female
Students Full Name
*
Your answer
Students current school (optional)
Your answer
What school year, is your child currently in?
*
Choose
1
2
3
4
5
6
7
8
9
10
11
12
N/A
Student's Date of Birth
*
MM
/
DD
/
YYYY
Home Address
*
Your answer
Any other relevant information (including medical or additional subjects)
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
