English Lessons Request Form First and last name(required) Email(required) “When I speak English, I get embarrassed. When I want to communicate an idea, people don’t understand my message. My limited vocabulary makes me feel awkward and I struggle to keep a conversation going.” Do you relate to this?(required) Yes No Do you feel like you wish you had more chances to speak to someone in English? (required) Yes No Do you want to improve how you communicate your ideas in English? (required) Yes No Do you want to be more committed to improving your English?(required) Yes No Can you commit at least 1 hour a week?(required) Yes No How many times per week do you engage in long form conversational** English? **be able to have a one to one conversation at a normal speaking pace with a native speaker, understanding 90% of what they hear and being easily understood by the person they are talking with.(required) Less than once a week Between 1 to 3 times a week More than 3 times a week Who will be paying for the lessons?(required) Me Someone else Why do you want to improve your English?(required) Please refer to the image above. How would you describe your current level of English proficiency and where would you like to be?(required) You will need to come prepared for the lesson. Full terms and conditions can be found here.Please agree to the following terms before booking. I will have a headset/earbuds for the lesson(required) I will have tested my equipment(required) I will be ready to join the video call at the scheduled time(required) I understand that I may receive future emails in relation to English lessons(required) I understand the terms and conditions(required) Will you have your credit card ready to pay the $1 for the trial class? Yes, I will have my card ready(required) Submit
