Students Learning & Skills Academy

Official Admission & Registration Form

1 Student Information

First Name *

Second Name *

Gender *

Date of Birth *

Age in Years

Department

Class *

Subject / Programme

Current School

Ethnic Origin

Identification Type (Optional)

ID Number (Optional)

Home Address *

Post Code *

2 Parent/Guardian Details

Father/Mother Name *

Occupation

Contact Telephone *

Email Address *

Please enter in CAPITAL LETTERS

Emergency Contact Name *

Emergency Number *

3 Learning & Support

Does your child have a disability, health issues or barrier to learning that may affect his/her study? *

Yes No

4 Emergency & Medical

Known Medical Conditions

GP/Doctor Phone

Doctor's Name

Doctor's Address / Clinic

5 Payment Section (£25 Registration Fee)

Important: Send your payment now, tuition is due before the class begins. Please make Cheque or Bankers' Order payable to SLASA LTD.

Cheque

Cash

Bank Transfer

Standing Order

Online Payment

6 GDPR & Consent

I consent to the Academy taking photographs and videos of my child for educational purposes, and I agree to the Privacy Policy and Terms & Conditions regarding data storage.

Digital Signature *

Draw Signature Here

Print Name

Date

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