Student Name
*
First Name
Last Name
English/Preferred name (if required)
Nationality
*
Gender
*
Male
Female
Non-binary
Date of birth
*
-
Month
-
Day
Year
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Mobile Phone
*
Name
*
First Name
Last Name
Relationship to student
*
Level of English of the parent/guardian
*
Please Select
None
Basic
intermediate
Fluent
Address
*
Country
*
Mobile Phone
*
Home Telephone
Email address
*
Name
*
First Name
Last Name
Relationship to student
*
Mobile Phone
*
Email address
*
What is the student's current level of English?
*
A0 (Complete Beginner)
A1 (Beginner)
A1-A2 (Elementary)
A2 (Pre-Intermediate)
B1 (Intermediate)
B2 (Upper Intermediate)
C1 (Advanced)
C2 (Proficiency)
Please give details of any English courses and examinations your child has taken (date taken/grade achieved). Please note that proof of their level of English will be required at a later stage and before the start of the course.
*
Are you booking with a local agent?
*
Yes, I am booking with a local agent
No, I am booking directly with the school
Please tick the dates you would like to study with us.
*
6 July 2025 - 20 July 2025
20 July 2025 - 3 August 2025
3 August 2025 - 17 August 2025
Please choose your preferred faculty
*
Computer, Science and Artificial Intelligence
Medicine, Health and Biomedical Science
Law and Global Justice
Engineering and Science
Business, Finance and Enterprise
Accommodation options:
*
I want to book course and accommodation
I want to book course only, I do not need accommodation
Would you like to take part in the Online Research Programme as a supplementary course?
*
Yes
No
Passport number
*
Date of issue
*
-
Month
-
Day
Year
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Expiry date
*
-
Month
-
Day
Year
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Please upload a copy of the student's passport
*
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a) Does the student have any medical conditions or disability?
Yes
No
b) Does the student have any allergies?
Yes
No
c) Does the student have any dietary requirements?
Yes
No
d) Is the student taking any medication?
Yes
No
a) Does the student need any help with mobility?
Yes
No
b) Does the student need any help with social interaction?
Yes
No
c) Does the student need any support in the classroom?
Yes
No
e) Is there anything we should know or can do to support the mental health of the student?
Yes
No
f) If the student does not identify with their assigned gender at birth, please indicate the type of accommodation arrangement where they would feel most comfortable. This information helps us ceate a supportive and inclusive housing environment.
*
Date of arrival
-
Month
-
Day
Year
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Time of arrival
Arrival location
Arrival flight number
Date of departure
-
Month
-
Day
Year
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Time of departure
Departure location
Departure flight number
Will your child be using the airline's 'Unaccompanied Minor Service'?
Yes
No
Would you like us to arrange an airport transfer for your child?
Yes
No
Visa Type
*
Standard Visitor Visa (for study that is less than 6 months in duration)
Short-Term Study Visa (for English language courses between 6-11 months in duration)
Student doesn't need a visa
Signature
*
Date
*
-
Month
-
Day
Year
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Submit
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