Form Page: Courseregistration

COURSE REGISTRATION FORM

Surname:

First Name:

Program / Course

Date of Birth:

dd/mm/yyyy

Male

Female

Address 1

Address 2

Address 3

Post Code:

Borough:

How long have you lived in the borough

Email:

Qualifications

Are You

Mobile No:

for how long?

Your Ethnic Origin

Please let us know if you have a Disability

Yes

If yes please specify

Are you disavantaged

Yes

if yes please specifyl

The following questions will enable us to check if you are eligible for any grants that may be available:

Are you claiming benefits such as

Housing benefit

Family tax credit

Income benefit

Yes

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