Impact Tuition Academy Application
Harrow - Southall - Wembley - Coventry - Leicester
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I have read the Impact Tuition Academy terms and conditions (
www.ImpactTuition.com/TandC
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I agree to the terms and conditions, including a 4 week notice period and informing the centre 48-hours before any absence
How did you hear about us?
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Your answer
Which centre are you applying for?
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Tuesday: Southall (Villiers School, UB1 3BT)
Wednesday: Wembley (To be confirmed)
Thursday: Harrow (Harrow High School, HA1 2JG)
Which subjects would you like to study?
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Maths
English
Science
11+ (Preparation for Grammar School entrance examinations)
Required
Email Address
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Your answer
Parents name
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Your answer
Home telephone number
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Your answer
Parents mobile number
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Your answer
Parents 2nd mobile number (optional)
Your answer
Student's Gender
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Male
Female
Students Full Name
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Your answer
Students current school (optional)
Your answer
What school year, is your child currently in?
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Choose
1
2
3
4
5
6
7
8
9
10
11
12
N/A
Student's Date of Birth
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MM
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DD
/
YYYY
Home Address
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Your answer
Any other relevant information (including medical or additional subjects)
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