STUDENT DETAILS

LESSON ACCESS/GOALS

KNOW YOUR CHILD

CLASS SCHEDULING

APPLICATION FORM FOR YOUNG LEARNERS

Child's Name *

Date of Birth *

Child's Age

Gender

Select your Country *

Select your city & time zone

What language(s) does your child speak at home? *

PARENT / GUARDIAN INFORMATION

Parent name *

Email Address *

Phone Number (Optional)

LESSON ACCESS INFORMATION

What device will your child use for class?

Laptop/Desktop

Tablet

Smartphone

Do you have Zoom or Skype installed?

Yes, I do.

No, I don't. (We'll help you set it up)

LEARNING GOALS

Has your child learned English before?

Yes

If Yes, please share a bit more:

What do you hope your child will learn at Smart Speak?

Speaking and confidence

Vocabulary

Reading

Writing

Listening skills

Conversation practice

Exam preparation (e.g. Cambridge, TOEFL Primary)

What are your child's favorite things? (Check all that apply)

Sports

Drawing

Games

Reading

Music

Movies/TV

Other:

How would you describe your child's personality?

Shy

Outgoing

Curious

Talkative

Quiet but focused

Other:

Is there anything special we should know about your child?

(learning style, behavior notes, special interests, etc.)

When is your child usually free for lessons? (Your local time) Select all that apply

Weekdays Morning

Weekdays Afternoon

Weekdays Evening

Weekends Morning

Weekends Afternoon

Weekends Evening

How many lessons per week are you considering?

1 lesson per week

2 lessons per week

3 or more lessons per week

Not sure yet

APPLICATION FORM FOR YOUNG LEARNERS

PARENT / GUARDIAN INFORMATION

LESSON ACCESS & LEARNING GOALS

GET TO KNOW YOUR CHILD

CLASS SCHEDULING