Contact Exceptional Academics
Please use this form to tell us about your child and the services you are interested in.
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Email *
Parent / Guardian Name *
Parent/Guardian Relationship to Child *
Address *
Postcode *
Phone number *
Service(s) Required
(please select both In-Person Tuition and Online Tuition if you are amenable to either) *
Required
Child's Name *
Child's Year Group *
Child's Gender *
Child's Date of Birth *
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/
DD
/
YYYY
Child's Current School *
Child's Personality
Learning Style
Areas of Weakness
Special Learning Needs
For Tuition: Exam Level
For Tuition: Subjects Required
If you have selected GCSE/IGCSE or A-Level, please specify your child's exam board(s) if possible
Ideal Tuition Start Date
MM
/
DD
/
YYYY
Day & Time Availability
Schools your Child is Applying to (in order of preference):
How did you hear about EA? *
In order to proceed, we need your consent to add your details to our tutor management software: Tutorcruncher. This is the platform we use for logging lessons, creating reports and sending invoices. We send occasional communications to parents about our forthcoming courses or relevant information about our services, but please rest assured that you won't be inundated with marketing emails. *
Required
We may occasionally photograph the children during our courses (online and in person) for use on our
website and for marketing purposes (including social media). If you do not agree to this, please tick the
box here:
 *
Required
Have you read, understood and agreed with the Terms and Conditions in which our fees are listed? By clicking Yes you are agreeing to terms and conditions of the contract between Exceptional Academics and yourself as the client. 
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Required
A copy of your responses will be emailed to the address you provided.
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