Newton Tuition Academy
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Application Form
Student's Name
*
Student's Name
First
First
Last
Last
Gender
*
Male
Female
Other
What year are you in (at school)?
*
Current School name
*
Student's contact Email
*
Student's Phone No:
Parents/Guardian Name:
*
Parents/Guardian Name:
First
First
Last
Last
Relationship to student:
*
Parents/Guardian Email
*
Parent's Phone No:
Emergency contact numbers:
*
Select your course from the list:
*
11 Plus
Pre GCSE
GCSE
AS Level
A2 Level
University (Foundation Year)
Sport
Arabic
Other
Select the subject(s) you want to study: (You can select more than one)
*
11 Plus (All)
Maths
English
Chemistry
Biology
Physics
Sport
Arabic
Other
Would you attend lessons online or in-class?
*
Online
In-class
Other
List the Exam Boards for each subject you are applying for: (AQA, Edexcel ...
Do you have Brothers/Sisters Enrolled at our academy (Give their names and classes please):
Select ALL POSSIBLE days and times you are available to attend classes:
*
Monday: 6pm-9pm
Tuesday: 6pm-9pm
Wednesday: 6pm-9pm
Thursday: 6pm-9pm
Friday: 6pm-9pm
Saturday: 10am - 1pm
Saturday: 1pm - 4pm
Sunday: 10am - 1pm
Sunday: 1pm - 4pm
Does the student suffer from any serious or long-term illness, e.g. Epilepsy, Bronchitis etc?
*
Yes
No
Please give details:
Does the Student require any special (educational or other) needs?
*
Yes
No
Please give details:
Does the Student suffer from any allergies?
*
Yes
No
Please give details:
Other information (Optional):
Please read our
Terms and C
on
ditions
NB: Tuition fees are non-refundable after the start of first week of the course.
NB: TuitionI have read and agree for the Terms and Conditions
*
Yes
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