Heath Kirby Tutoring - New Student Enquiry

New Student Enquiry

Heath Kirby Tutoring

Please complete this form to the best of your ability. The more information that you provide, the more that we can assist by understanding your needs.

Completing this form will enter your details into our Client Portal.
Please note: We have tutoring Terms and Conditions that you will be provided with once this form is completed.
If you have contacted us through other avenues, the Terms and Conditions are provided to you.

First Name

Last Name

School

Level of study (Undergraduate, Postgraduate, Honours, PhD)

Subjects

Address

Address Line 2

City

State

Zip

Country

How can we help you?

Subjects being tutored (name and unit code)

Strengths, Weaknesses, Focus Areas - tell us where you want help specifically

Have you ever used a tutor before? If yes, can you talk a little about your experience with tutoring previously. In particular, what worked best for you? If you have never used a tutor before, you may wish to complete the information below to tell us more

Any specific information you would like your tutor to know? (special needs, how you learn best). *

When do you plan to finish your current study? This helps us plan our business.

Do you agree to our Terms and Conditions?

What motivated you to choose Heath Kirby as your tutor?

I consent to any photos and images that may be taken of me while working with Heath Kirby Tutoring to be used for promotional and other purposes (I will not be identified)