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Academic Private Student Enrolment
Academic Private Student Enrolment
Please enable JavaScript in your browser to complete this form.
Name
*
First
Last
Date of Birth
*
Which Language are you Interested in?
English (ESL)
French
Spanish
Portuguese
German
Italian
What are you Studying?
GCSE
AS/A Level
Degree or Above
In-person or Online Classes?
*
In-Person*
Online
*In-person subject to being in the Teesside area
What Days are Best for you?
*
Monday
Tuesday
Wednesday
Thursday
Friday
What Times are Best for you?
*
Morning 8am-12pm
Afternoon 12pm-5pm
Evening 5pm-9pm
Email
*
Contact Number
*
Postcode
*
*This is to determine whether in-person facilities are available to you
Permission & Agreement
*
I agree and give my permission
I hereby give permission for Miss Harmonie to contact me via the details above. Your details will not be shared with anybody but Miss Harmonie may send me emails about upcoming classes and money saving deals.
Submit