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Please fill this short registration form .

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Please select the level that applies

KS2
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Please select the subjects you are interested in

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SPACE centre - Survey

Are you interested in the centre for creative learning? This takes place in your local library. If so, please complete this very short survey.

Name *

First

Last

Email *

Phone:

I am a ...

Parent
Student
Tutor

Which level applies to your child?

KS2
KS3
KS4
KS5

Do you welcome the idea of a centre for creative learning?

Yes
No
Not particularly

Would you like your child to attend?

Yes
No
Not particularly

Is your child struggling at school?

Yes
No
Not particularly

Which subject is your child being tutored for?

English
Mathematics
Science
Biology
Chemistry
Physics
other
none

If other, please specify

Which subject would you like tutoring for?

English
Mathematics
Science
Biology
Chemistry
Physics
other
none

If other, please specify

When is the best time to contact you?

Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday

At what time?

Selected Value: 9

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