Welcome to Quillan Education. Thank you for choosing Quillan Education to champion your child. Please note that sessions may only be cancelled and rescheduled, by phone or email, no later than 24 hours prior to a coaching session.

Parent Telephone Number *

Preferred name/nickname *

Age at time of registration *

School Year *

Areas in which coaching is required *

Any additional needs/ information *

Preferred start date *

Preferred frequency in days per week *

Preferred days of the week *

• Monday
• Tuesday
• Wednesday
• Friday

Preferred hours *

• 10 - 11
• 11 - 12
• 12 - 1
• 2 - 3
• 3 - 4
• 4 - 5
• 5 - 6
• 6 - 7

Preferred engagement method: (Please select preference) *

• In person
• Online

Preferred Subjects and Activities

• Maths
• Science
• Chemistry
• Biology
• Physics

Parent Name & Surname: *

First

Last

Parent Email *

Parent Telephone Number *

Parent Postal Address *

Parent Postal Code *

Confirmation *

• Agree

I confirm that I am the parent / legal guardian of the student and that I have read and agree to abide by the terms and conditions provided in this Student Registration

Signed (Name or E-Signature) *

Location *

Date *

Submit

Terms, Conditions and Rates Services
Quillan Education provides a cognitive assessment, as well as coaching in science, maths, learning strategies and exam skills. The services are provided on a personal basis.  Quillan assesses the specific needs of the student, using existing tried and tested scientific assessment tools, to enable a tailored assessment report and personalised coaching program for each student. A minimum of 4 coaching sessions is required, after which progress and further needs are assessed. Coaching may be provided either online or in person. More information is available at www.quillaneducation.com.  Personal attendance is required for the assessment session. All coaching sessions are one-to-one and may be in person or online, based on circumstances and preference. Quillan has a preference for most sessions to be conducted in person to ensure a high-quality coaching relationship with the student.

Rates

Payment Terms
All sums are payable by electronic transfer in
advance to:

Cancellation, rescheduling & refunds

Providing notice is provided to Quillan by phone or email, no later than 24 hours prior to a
coaching session, sessions may be cancelled and rescheduled. Refunds will be made at the sole discretion of Quillan, only pro-rated, for services not yet provided and based on reasonable grounds. Quillan Student Registration Form V1.0

Data Protection & Privacy

Quillan will not, under any circumstances share client or student information with any other party unless required to do so by law and will take the necessary steps to ensure that client or student information is stored in a secure manner.

Safeguarding

Quillan Education operates in accordance with the Department of Education’s guidelines “Keeping children safe in education 2021(KCSIE 2021) with specific risk assessments for in person and online environments.
https://www.gov.uk/government/publications
/keeping-children-safe-in-education–2