[ELS] Academic Course Registration Form

Academic Registration Form

Fill out the form carefully for registration
Candidate's Name

First NameMiddle Name (where applicable)Last Name
Birth Date

DayMonthYear
Gender
Address

Address 1

Address 2

CityState / Province

Postcode
Phone Number
Format: 00000000000.
E-mail

Confirmation Emailexample@example.com
Unique Candidate Identification Number (UCI) if known
Bill Payers Name & Address
If applicable, please enter bill payers details
Qualification
Please select entry you want made
Exam Board Please select Examination Board - if unsure please leave blank.
Subjects
Please indicate the subjects you would like to take. E.g Mathematics, Biology, Spanish etc including the subject course code.
Higher, Foundation or Level
If the qualification is tiered, which level would you like to be registered for.
Additional Course Options
.
Do you require Access Arrangements?
Signature
Date
Would you be interested in tuition or revision classes for GCSE, IGCSE, A Level & Functional Skills. All subjects available.
How did you hear about us?

Other (Please specify)
Terms and Conditions
You are required to pay any fees outstanding before we can proceed with your exam entry. Candidates (or their parents/guardians) can make a payment with cash in person at our centre or via an online bank transfer payable to East London Skills for Life bank account.

East London Skills for Life Account number : 61601571 Sort Code: 40-06-30
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Academic Registration Form