Student Form – Esther's Eloquence Emporium

1

Basic Information

Let's start with the essentials so I know who I'm speaking with.

Full Name *

Please enter your name.

Age

City & State

Email Address *

This is how I'll get in touch with you.

Please enter a valid email address.

Occupation / Student Status

How did you find me? (select all that apply)

2

Your English Background

Help me understand where you're starting from. There is no wrong answer here.

Current English level

Beginner: I know very little or almost nothing yet Elementary: I know basic words and simple phrases Intermediate: I can hold basic conversations but struggle sometimes Upper Intermediate: fairly comfortable and ready to improve Advanced: fluent but want to refine and polish Not sure: I'd like you to help assess me

CEFR Level (optional, if you know it)

IELTS/study-abroad students often know this. If you don't, skip it.

Skills you struggle with most (select all that apply)

Have you studied English before?

Yes, formally through school, coaching, or tutoring Yes, casually through apps, YouTube, or self-study No, this would be my first time

Language(s) spoken at home

3

Your Learning Goals

The clearer your goals, the more targeted our sessions will be.

Why do you want to improve your English? (select all that apply)

If we could improve only ONE thing first, what should it be?

This helps me focus our first sessions where it matters most to you.

Biggest challenge when speaking English

What would you like to achieve in the next 3–6 months?

Do you prefer:

Structured lessons with clear topics, grammar, and exercises Casual conversation practice with relaxed, natural dialogue Mixed, with a bit of both

4

Learning Style & Personality

Everyone learns differently. This helps me plan sessions that work well for you.

How do you learn best? (select all that apply)

Visual examples Conversation practice Repetition & drilling Games & activities Homework & tasks Real-life examples

Are you comfortable making mistakes while learning?

Yes, I know mistakes are part of the process A little nervous, but I'm working on it Not really. It's something I'd like to work through

Do you prefer a teacher who is:

Patient & encouraging, at my pace Firm & corrective, with direct feedback and a push Balanced, with a healthy mix of both

Willing to do short practice tasks between sessions?

Yes, I understand practice outside class matters Sometimes, depending on the workload I prefer only in-session learning

5

Scheduling & Availability

Consistency is key. Let's find a time that works for you every week.

Preferred Timing (IST)

Preferred Class Duration

30 minutes, short & focused 45 minutes, a good middle ground 60 minutes, a full session for deeper work

Sessions per week

Preferred session platform

Zoom Google Meet No preference. Whatever works best

Internet connection & device quality

Available for a short trial session first?

Yes, I'd love to try before committing No, I'm ready to start directly Maybe. Let's discuss

6

Investment & Commitment

Understanding your budget helps me suggest a package that's comfortable for you. All responses are private.

There's no pressure at all. Every package is discussed personally, and I just want to know what's comfortable so we can find the right fit.

Monthly budget for coaching

Are you looking for:

Short-term, with a focused push for a specific goal Long-term coaching for an ongoing learning journey Trial sessions first, so we can see if we're a good fit Not sure yet. Let's talk

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A Few Final Questions

These help me understand your mindset so I can support you in the right way.

Anything you feel nervous or hesitant about in this learning journey?

This is a safe space. Nothing you share will be judged.

What kind of learning environment helps you stay focused?

Anything else you'd like me to know before we begin? (optional)

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Before You Submit

Please read and confirm the following. Both are required to submit.

Please confirm this to continue.

Received!