New Student Enrollment Inquiry — Kickoff intake form (public) for Education. Embeddable version — a transparent, chrome-free form that floats over your own website design (pair with the standalone version for a hosted page).

A few details about the student and what they want to achieve so we can recommend the best program. Parents and guardians, please complete this for a student under 18. Takes about five minutes.

What it collects (by section):

• About you & the student — First name [short text]; Last name [short text]; Email address [short text]; Contact Role (education) [dropdown: Student / Parent/Guardian / Adult learner / School administrator / Counselor / …]; Enrollment Intent (education) [dropdown: Course enrollment / Tutoring package / Exam prep / Consultation only / Program info]; Program Level (education) [dropdown: Elementary / Middle school / High school / College/University / Adult/Continuing / …]; Age Band (education) [dropdown: <10 / 10-12 / 13-15 / 16-18 / 19-22 / …]; School / Institution Name [short text]; School Year / Term [short text].
• Goals & focus — Primary Learning Goal (education) [short text]; Learning Goal Categories [multi-select: Grade improvement / Skill mastery / Catch-up/remediation / Acceleration/Enrichment / Credit recovery / …]; Subjects / Areas of Focus [multi-select: Math / Reading/Writing / Science / Social Studies / Languages / …].
• Anything else — Scholarship/Financial Aid Interest [dropdown: No / Yes - info requested / Yes - applied / Approved]; Education Notes (client-specific) [long text].

Required: Email address, Contact Role (education), Enrollment Intent (education) (kept low-friction).

Form type: Kickoff intake (in), public. Niche: Education. Deployment: embed.

Best for / surface when: A tutoring or test-prep program intaking new students — captures the contact role, enrollment intent, program level, and learning goals to recommend the right path (parents complete it for minors).