intake form by FB80043

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									                               Intake form for English tuition
By filling in the intake form below, Into English will be able to send you a tailor-made offer for
English tuition. Subsequently, there will be a free, non-binding intake (in person/by Telephone/via
Skype video conference) to discuss the intake form, offer and lesson plan.


Name:
Nationality:
Please make your answer bold

1. Do you want English for:

a. an individual
b. a group
If you have answered b., please indicate group size:
2.When would you like tuition:
                                  From _______ until _________
                                  (please fill in the approximate period)
3. How often would you like
tuition during this period?
                                  a. _______days/week
                                  b. _______hours/day
                                  (please fill in both a. & b.)
4. What would you like to focus
on:
                                  a. grammar, specifically:_____________________________
                                  b. vocabulary, specifically:___________________________
                                  c. speaking, specifically:_____________________________
                                  d. listening, specifically:_____________________________
                                  e. reading, specifically:______________________________
                                  f. writing, specifically:_______________________________

                                    (more than one answer is possible)
5. What would you like to use
your English for i.e. what is the
goal of the tuition?
                                    Answer:




6. Is there a specific language
focus/subject    matter      e.g.
marketing, sport, health, etc.?
                                    Answer:
7. Where would you like to
receive tuition?
                             Answer:




8. Do you have any other
comments/requirements?
                             Answer:

								
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