Electronic Enrolment Form Step 1 of 3 - Student and Parent Details 0% Student DetailsStudent Name(Required) First Middle Last Gender(Required)MaleFemaleOtherAcademic School Year(Required)123456789101112Date of Birth(Required) DD slash MM slash YYYY Home Address(Required) House number and street Address Line 2 City Post Code Current School(Required) Parent DetailsParent's Full Name (Primary Contact)(Required) First Middle Last Relationship to Student(Required) Telephone Number(Required)Your Email Address(Required) Emergency Contact DetailsEmergency Contact Name(Required) This should be someone other than the Primary Contact.Emergency Contact Telephone Number(Required)This should be different to the Primary Contact number.Relationship to Student(Required) Emergency Contact Address Same as student address House number and street Address Line 2 City Post Code Enter if different to the home address of the student.Course DetailsCourse Selection(Required)KS1 English and Maths Booster Class (Year 1)KS1 English and Maths Booster Class (Year 2)KS2 English and Maths Booster Class (Year 3)KS2 English and Maths Booster Class (Year 4)KS2 English and Maths Booster Class (Year 5)Year 6 SATs Preparation Class (and Transition to Secondary School)11+ Exam Preparation Class (Foundation Year 4)11+ Exam Preparation Class (Advanced Year 5)KS3 English (Year 7)KS3 Maths (Year 7)KS3 Science (Year 7)KS3 English (Year 8)KS3 Maths (Year 8)KS3 Science (Year 8)KS3 English and Maths (Year 7)KS3 English and Maths (Year 8)KS3 English and Science (Year 7)KS3 English and Science (Year 8)KS3 Maths and Science (Year 7)KS3 Maths and Science (Year 8)KS3 English, Maths and Science (Year 7)KS3 English, Maths and Science (Year 8)Year 9 English Only (Year 9)GCSE English Only (Year 10)GCSE English Only (Year 11)GCSE English Only (Year 12)Year 9 Maths Only (Year 9)GCSE Maths Only (Year 10)GCSE Maths Only (Year 11)GCSE Maths Only (Year 12)Year 9 Combined Science Only (Year 9)Year 9 Triple Science Only (Year 9)GCSE Combined Science Only (Year 10)GCSE Triple Science Only (Year 10)GCSE Combined Science Only (Year 11)GCSE Triple Science Only (Year 11)GCSE Combined Science Only (Year 12)GCSE Triple Science Only (Year 12)Year 9 English and Maths (Year 9)GCSE English and Maths (Year 10)GCSE English and Maths (Year 11)GCSE English and Maths (Year 12)Year 9 English and Combined Science (Year 9)Year 9 English and Triple Science (Year 9)GCSE English and Combined Science (Year 10)GCSE English and Triple Science (Year 10)GCSE English and Combined Science (Year 11)GCSE English and Triple Science (Year 11)GCSE English and Combined Science (Year 12)GCSE English and Triple Science (Year 12)Year 9 Maths and Combined Science (Year 9)Year 9 Maths and Triple Science (Year 9)GCSE Maths and Combined Science (Year 10)GCSE Maths and Triple Science (Year 10)GCSE Maths and Combined Science (Year 11)GCSE Maths and Triple Science (Year 11)GCSE Maths and Combined Science (Year 12)GCSE Maths and Triple Science (Year 12)Year 9 English, Maths and Combined Science (Year 9)Year 9 English, Maths and Triple Science (Year 9)GCSE English, Maths and Combined Science (Year 10)GCSE English, Maths and Triple Science (Year 10)GCSE English, Maths and Combined Science (Year 11)GCSE English, Maths and Triple Science (Year 11)GCSE English, Maths and Combined Science (Year 12)GCSE English, Maths and Triple Science (Year 12)Centre Selection(Required)Select the centre you would like your child to study at...DudleyWalsallWolverhampton EnglishEnglish Language Exam Board(Required)AQACouncil for Curriculum and Examinations Assessment (CCEA)Pearson EdexcelOxford, Cambridge and RSA Exams (OCR)Welsh Joint Examinations Committee (WJEC)UnsureEnglish Language Target Grade123456789English Language Current Grade123456789English Literature Exam Board(Required)AQACouncil for Curriculum and Examinations Assessment (CCEA)Pearson EdexcelOxford, Cambridge and RSA Exams (OCR)Welsh Joint Examinations Committee (WJEC)UnsureEnglish Literature Target Grade123456789English Literature Current Grade123456789Shakespeare Text Studied (Select All Studied)(Required) Macbeth Romeo and Juliet The Tempest The Merchant of Venice Julius Caesar Unsure Modern Text Studied (Select All Studied)(Required) An Inspector Calls Blood Brothers Animal Farm Lord of the Flies Unsure 19th Century Novel Studied (Select All Studied)(Required) The Strange Case of Dr. Jekyll and Mr Hyde A Christmas Carol Pride and Prejudice Great Expectations Unsure MathsMaths Exam Board(Required)AQACouncil for Curriculum and Examinations Assessment (CCEA)Pearson EdexcelOxford, Cambridge and RSA Exams (OCR)Welsh Joint Examinations Committee (WJEC)UnsureFoundation Tier or Higher Tier(Required)Foundation TierHigher TierUnsureMaths Target Grade123456789Maths Current Grade123456789Combined ScienceCombined Science Exam Board(Required)AQACouncil for Curriculum and Examinations Assessment (CCEA)Pearson EdexcelOxford, Cambridge and RSA Exams (OCR)Welsh Joint Examinations Committee (WJEC)UnsureFoundation Tier or Higher Tier(Required)Foundation TierHigher TierUnsureDouble Target Grade (enter both grades) Double Current Grade (enter both grades) Triple ScienceBiology Exam Board(Required)AQACouncil for Curriculum and Examinations Assessment (CCEA)Pearson EdexcelOxford, Cambridge and RSA Exams (OCR)Welsh Joint Examinations Committee (WJEC)UnsureFoundation Tier or Higher Tier(Required)Foundation TierHigher TierUnsureBiology Target Grade123456789Biology Current Grade123456789Chemistry Exam Board(Required)AQACouncil for Curriculum and Examinations Assessment (CCEA)Pearson EdexcelOxford, Cambridge and RSA Exams (OCR)Welsh Joint Examinations Committee (WJEC)UnsureFoundation Tier or Higher Tier(Required)Foundation TierHigher TierUnsureChemistry Target Grade123456789Chemistry Current Grade123456789Physics Exam Board(Required)AQACouncil for Curriculum and Examinations Assessment (CCEA)Pearson EdexcelOxford, Cambridge and RSA Exams (OCR)Welsh Joint Examinations Committee (WJEC)UnsureFoundation Tier or Higher Tier(Required)Foundation TierHigher TierUnsurePhysics Target Grade123456789Physics Current Grade123456789 Additional Details and ConsentMedical Conditions(Required) Yes No Please Describe the Medical Conditions(Required)Any Special Educational Needs (SEN)(Required) Yes No Please Describe the Special Needs(Required)How did you hear about Excel Tuition?(Required)Select one of the options...EmailFacebook/Instagram/TwitterFamily or Friend recommendationGoogle/SafariLeaflet from SchoolA Sibling Currently AttendsLeaflet Posted to My HomeRadioTelevisionText MessageOtherTerms and Conditions(Required) Excel Tuition will be delighted to provide education and support to your child subject to you agreeing to the following terms and conditions. 1. Parents and children will be committed and enthusiastic about their child’s learning and development. 2. Parents and teachers will work together to develop their child’s learning in matters of homework, punctuality, behaviour and the like. Parents will be responsible for ensuring their child’s homework is completed before the commencement of the next lesson. 3. Parents will recognise the importance of their child’s regular attendance to class in order to progress. To this end they will ensure their child’s attendance is regular and punctual. 4. If a child needs to miss a lesson, parents are required to complete and submit an Absence Form, authorising their child to receive cover work for the missed lesson. No refunds are issued for missed lessons. 5. The cost of the lessons will be paid one month in advance at the start of the month. This is to ensure that those parents and children who are committed are given priority as class sizes are restricted. Students will not be allowed to attend any lessons that have not been paid for in advance. 6. Each lesson runs for two consecutive hours, apart from GCSE, Computer Science and Coding, which run for an hour. 7. The price for the courses are as follows:- - Key Stage 1 English and Maths Booster course (Year 1 and Year 2) is £12.50 per hour (£25.00 per two hour lesson). - Key Stage 2 English and Maths Booster course (Year 3, Year 4 and Year 5) is £12.50 per hour (£25.00 per two hour lesson). - 11+ Entrance Exam Preparation course is £13.50 per hour (£27.00 per two hour lesson). - Year 6 SATs Preparation course is £13.50 per hour (£27.00 per two hour lesson). - One Key Stage 3 course is £15.00 (£15.00 per hour), two Key Stage 3 courses is £27.00 (£13.50 per hour), three Key Stage 3 courses is £40.50 (£13.50 per hour). - One GCSE course is £17.00 (£17.00 per hour), two GCSE courses is £30.00 (£15.00 per hour), three GCSE courses is £45.00 (£15.00 per hour). - Computer Science and Coding course is £15.00 (£15.00 per hour). 8. Tuition fees must be settled before starting a tuition programme. 9. Accounts that are in arrears are subject to a £5.00 late payment fee for each week they are overdue, capped at three months. Any outstanding payments after three months are subject to a £40.00 administration cost, in addition to the cost associated with making a money claim with the county court. 10. A sibling discount of 5% is applicable for each younger child. The sibling must be from the same immediate family. Please note, sibling discounts are only applied when one or more sibling is enrolled on to a course at the same time. The sibling discount is removed once the other sibling(s) have ended their tuition and the prices are automatically reverted back to the full price. 11. Progress reports will be provided to parents at the end of each term. 12. On completion of a course your child will be automatically moved to the next course, unless we receive notification from you that you wish to end the tuition (see clause 15). Consequently, you understand and agree to be charged the price that is applicable to the new course. 13. In extreme weather (severe snow/earthquake/storms/floods etc) lessons may need to be cancelled, with no recourse to substitute lessons or cover work. 14. Covid-19: (a) In the event of the centre having to temporarily close due to government guidelines, we will arrange substitute lessons when the centre can re-open. The cost of the class will remain the same as prior to the centre temporarily closing. (b) In the case of a student needing to self-isolate, they should not attend the centre until the self-isolation period has been completed. No refunds will be issued for lessons missed due to self-isolation. We will arrange substitute lessons for students who are absent due to self-isolation. 15. Thirty days’ notice is required when you intend to withdraw your child from the Centre or end a tuition programme. Cancellation of each subject requires thirty days’ notice to be provided too. This needs to be provided by completing a Thirty Days’ Notice form. 16. Following notice to withdraw your child from the Centre or end a tuition programme, any closing balances are required to be paid before the commencement of the next lesson. 17. You have a right to cancel your contract and membership agreement within 14 days of signing the contract (14 day cooling-off period). Cancellation must be made by emailing admissions@exceltuition.net. No other method of cancellation is accepted. Any lessons attended during the 14 days will need to be paid for at the normal rate (see pricing tables on website). A £30 charge will also be applied for assessments. All exercise books issued will be charged at £3 per exercise book. 18. In the case of continual absence, tuition fees will be charged as normal; only the Thirty Days’ Notice Form will end the tuition and charges (see clause 15). 19. Parents/carers who are over ten minutes late collecting their child after their class time finishes, will be charged a supervision fee of £5 per child for the first 15 minutes, then £1 per minute thereafter. 20. These terms and conditions are subject to change from time to time without prior notice. I have read, understood and accept these terms and conditions.Consent(Required) I understand that if my child misses a lesson, I must complete and submit an Absence Form, after which my child will be given cover work. No refunds are given for missed lessons (see clause 4).Consent(Required) I understand that all lessons must be paid for one month in advance at the start of the month. Students will not be allowed to attend any lessons that have not been paid for in advance (see clause 5).Consent(Required) I understand that I need to provide thirty days’ notice when I intend to withdraw my child from the Centre or end a tuition programme. Cancellation of each subject requires thirty days’ notice to be provided too. This needs to be provided by completing a Thirty Days’ Notice Form (see clause 15).Consent(Required) I understand that following notice to withdraw your child from the Centre or end a tuition programme, any closing balances are required to be paid before the commencement of the next lesson. (see clause 16).Your Signature(Required)