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Please enable JavaScript in your browser to complete this form.Name *FirstLastDate of Birth *Email *Mobile: *Subject: *MathematicsEnglish LiteratureEnglish LanguageBiologyChemistryPhysicsHistoryGeographyModern Languages (Please specify)Other (Please specify)Please specify:Level of Study: *Key Stage 3 (Year 7-9)GCSE (Year 10-11)A-Level (Year 12-13)Examination board: *AQAEdexcelOCROther (Please specify)Please specify:Specific topic(s) or areas you want to focus on?What days are you available for tutoring? (Check all that apply) *MondayTuesdayWednesdayThursdayFridaySaturdaySundayWhat times are you available for tutoring? (Check all that apply) *Morning (08:00-12:00)Afternoon (12:00-16:00)Evening (16:00-20:00)Night (20:00-22:00)Goals/ Objectives: *Improve gradesPrepare for GCSE examsPrepare for AS/A-Level examsUnderstand specific topics betterComplete homeworkOther (Please specify)Please specify:How would you describe your current performance in the subject(s)? *ExcellentGoodAverageBelow AveragePoorAny additional comments or questions?Consent for the recording and use of images and video *I give consentI do not give consentDuring UK2Learn's online lessons we may wish to take a photograph or video recording parts or all of your lesson either for our own records, for use as part of our learning curriculum or for inclusion in our promotional material such as our brochure, marketing emails and our website. To comply with the Data Protection Act 1998 and the new General Data Protection Regulation (May 2018), we need to ask for your consent before the school or the media record any images of you or your son/daughter. In view of this, please read the statement and select an option below. 1. We may use your/your son or daughter’s photograph in our brochure, marketing emails and other publications we produce for promotional purposes. 2. We may use your/your son or daughter’s image on our website and social media. 3. We may record your/your son or daughter’s image on video. 4. Your/your son or daughter’s image may appear in the media. 5. Your/your son or daughter’s first name may appear with the image in the media. 6. Your/your son or daughter’s image will be stored on our management systems to help staff identify students. You have the right to withdraw consent at any time. Should you wish to withdraw consent, please contact us.CommentSubmit
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