Intake Form: Meet The English Center
Email *
First Name *
Last Name *
Mobile phone number *
Employment *
Your current job or the kind of work you want. Or if you are a university student, tell us what you study.
Motivation *
Why do you want to improve your English?
Special dates
Do you have a holiday coming soon? Or are you preparing for a test, interview, presentation, etc.? Tell us.
Best lesson location for you *
You can say: "Amsterdam", "Amstelveen, "my company office", "Den Haag" or "I don't know."
Length / Time / Frequency *
Do you know how long you would like each lesson to be? 60 minutes? 90 minutes, etc.? What day and what time of day is best for you? How often do you want to have a lesson? Once per week? Twice per week? Every day?
Start date *
When would you like to start studying? ASAP, next month, etc.
Test
Would you like to take a level test? For most private students, it is optional.
Book(s) *
Specify the books or say "no books" or "I don't know."
English Central Video Training *
Do you know what kind of video content you would like for video homework? You can say "Business English", "Academic English" or "I don't know."
Package
Do you have a budget in mind?
Lesson plan *
What will your lessons focus on? You can say general English, Business English, job interview English, pronunciation, writing, etc.
More
What else should we know?
Teacher
What city do you live in? *
In what city do you work or attend school? *
Your home address: house or apt. number, street, city, country, postcode *
Invoice (factuur) email infomation *
If you become a client, the email address we will use to invoice you (factuur sturen).
Type this code: UPUT6V *
This code is to verify you are a human. Protected by xfanatical.
Submit
Never submit passwords through Google Forms.
This form was created inside of The English Center. Report Abuse