LearnersBox Tuition Pre-registration Form
Registration begins 1st September 2014. Please provide your contact details and services you are interested so that we can forward you with extra information and contact you once our registrations open.
We will hold your personal information on our systems for as long as you use the service you have requested, and remove it in the event that the purpose has been met or when you no longer wish to continue your subscription.
Under the Data Protection Act 1998, we have a legal duty to protect any information we collect from you. We use leading technologies and encryption software to safeguard your data, and keep strict security standards to prevent any unauthorised access to it.
We will not pass on your personal details to any third party without your permission.
* Required
Your name
*
Please provide your first and last name
Your answer
Students name
*
Please provide the students first and last name
Your answer
Students age and year group (academic year 2014/15)
*
Age (Years), Year Group (please use a comma to separate)
Your answer
What services are you interested in?
*
Tuition
Medical Coaching
Other:
Required
If you have selected tuition, please select which subject(s) you are interested in
Science – Key Stage 3
Biology – GCSE
Biology – A-Level
Chemistry - GCSE
Chemistry - A-Level
Physics - GCSE
Physics - A-Level
Mathematics - KS3/KS4
Mathematics - A-Level
English - KS3/KS4
Other:
Please provide an email address
*
We will send you further details via email
Your answer
Please provide a phone number
(Optional) So that we may contact you with further details
Your answer
If you have any questions, require more information or you want to tell us anything else, please write it below.
(Optional)
Your answer
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