Online ESL Lesson Booking Form

BOOK YOUR SESSION

Learn English with me! I provide online English lessons via Zoom for beginners to advanced students. If you just want to have a conversation with a native English speaker, or a more structured lesson with goals and objectives - I am the perfect teacher for you. I have over 3 years of experience teaching English both in a classroom and online, so book your lesson today and start your English language journey!
Name*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Address*

Street Address

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CityState / Province

Postal / Zip CodeCountry
Beginner - No Previous ExperienceA1A2B1B2C1C2Business English
Your Time Zone/Country*
Lession Date & Time*

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DateHourMinutes
Number of People in Session*
Name & Age of Student(s)*
For how long have you been studying English?*
Note to Teacher
Student Agreement/Contract/Waiver/Copyright Acknowledgment & Policies
I AgreeI DO NOT Agree
Refunds and Cancellation Policy: I have read and agree to the following statement: I understand that if I cancel my lesson with LESS than 24 hours notice, I will not receive a refund or be able to reschedule my lesson. Should the lesson be cancelled or rescheduled with LESS than 24 hours notice by John White's Learning Village, I am entitled to a full refund if I choose NOT to take the class. If I accept the rescheduled lesson, no refund will be given.*

I AgreeI DO NOT Agree
By signing (draw your signature) below I certify that I am at least 18 years of age. I have read this student agreement/waiver/contract and fully understand the contents thereof. I agree that I have the legal authority to grant these permissions and accept all responsibility for such.*
My Products
prevnext( X )
Conversational English with a Native£15.00

Structured Speaking Lesson£18.00

Reading£15.00

Grammar£15.00

TEST£1.00

Total £0.00
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BOOK YOUR SESSION

Student Agreement/Contract/Waiver/Copyright Acknowledgment & Policies