Registration

Registration form

First name *

Family name *

Preferred Name *

Nationality *

Date of birth *

Gender

Male

Female

Passport number *

Passport expiry date *

Email Address *

Mobile number *

Name of school in UK *

Start date at school in UK *

Course or Year Group e.g. GCSE or A Level *

Any health issues?

Yes

No

If yes, please provide details:

Any allergies?

Yes

No

If yes, please provide details:

Mother’s details

First name *

Family Name *

Nationality *

Occupation *

Email Address *

Mobile Number *

Home Address *

Father’s details

First Name *

Family Name *

Nationality *

Occupation *

Email Address *

Mobile Number *

Home Address *

Do you have an educational agent?

Yes

No

If yes, please tell us their name:

Photo *

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Regent Guardians Ltd. is registered in England and Wales. Registered address Goodwood House Blackbrook Park Avenue Taunton Somerset TA1 2PX
Registered Company Number 11191018