Student Registration Form
Student's title
*
Student's Full Name
*
Student's Email Address
*
example@example.com
Student's Date Of Birth
*
/
Month
/
Day
Year
Date
Student's Full Address
*
Student's Nationality
*
Select the school year of the student
*
Please Select
Year 7
Year 8
Year 9
Year 10
Year 11
Parent/ Guardian Title
*
Parent/Guardian Full Name
*
Parent/ Guardian Email Address
*
Confirmation Email
example@example.com
Parent/Guardian Contact Number
*
How did you hear about us?
*
Please Select
Search engine (Google, Bing, etc.)
Instagram
WhatsApp
Students/Parents
Other
Other
Student's current achieved or predicted grade for English
Exam board for English Language
Student's current achieved or predicted grade for Maths
Exam board for Maths
Student's current achieved or predicted grade for Science
Exam board for Science
Please select the cohort to enrol the student in
*
Please Select
Years 7-8
Years 9-10
Years 10-11 (GCSE cohort for the current academic year)
I understand and confirm that the information provided on this form is complete and accurate
*
Please Select
Yes
No
Please select your subscription package
*
Please Select
Monthly - £65
3 Months - £180
5 Months - £300
Signature of student
*
Signature of parent/ guardian
*
Any questions for us?
Submit
Should be Empty: