Online Registration

Please complete the below enquiry form and we will be in touch with you shortly

First Name:

Surname:

Date of Birth:

Contact Number:

Email Address:

Name of Parent/Guardian:

Address:

School Name:

Current Year/Class:

Please specify the Exam board (Year 9-11)

Edexcel

OCR

AQA

Foundation

Higher

Does your child have a physical/ learning disability?

Yes No

(If yes, please give details):

Does your child take any medication at present?

Yes No

(If yes, please give details):

Emergency Contact other than parent/guardian named above:

Name:

Contact Number:

How did you hear about KLC:

Ethnic Origin (Please specify):

Permission for my Child (ren) to be photographed, or their images recorded for print or electronic use in promoting out tutoring services.

Yes No

We may contact you for marketing purposes
via text message/email/telephone call

Yes No

As parent/guardian I acknowledge that I have read and agree to the Terms & Conditions.

Promotional Code:

Thank you. The Mailman is on His Way :)

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