New Registration

Student first name*

Student last name*

Student date of birth*

(dd/mm/yyyy) (e.g 15/06/1995)

Student gender*

Father`s name*

Father`s mobile number*

Starts with 0 i.e 07500000000

Mother`s name*

Mother`s mobile number*

Starts with 0 i.e 07500000000

Home telephone*

Starts with 0 i.e 02000000000

Parent email*

Parent/Student address line 1*

Parent/Student address line 2

Parent/Student borough*

Parent/Student postcode*

Emergency contact name 1*

()

Emergency contact number 1*

(Telephone or Mobile - Please ensure this is not parent`s contact number)

Emergency contact name 2*

()

Emergency contact number 2*

(Telephone or Mobile - Please ensure this is not parent`s contact number)

Student school

Student school address

Language spoken 1*

Language spoken 2

Allergies and medication (please list all)*

Any other information you would like to share with us

I have read the rules and regulations of the School and agreed to abide by them.

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