Learner Self-Registration - Gallery Teachers

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Which school and location are you attending?*
Are you attending as part of a group?*
Which group are you part of?
If you are attending as part of a group please input the name of your group leader / teacher / group organiser.
Start Date
Finish Date

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Learner Name*
First Middle Last
English Name
Gender*
Date of Birth*
Nationality*
Passport Number
Passport / ID Expiry Date
Home Address*
Street Address City County / State / Region ZIP / Postal Code Country
Email*
Phone*

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Parent / Next of Kin / Guardian Name*
Contact Number*
Relationship to Student*
Does the student have any special dietary needs?*
we can cater for different dietary requirements, as long as we are told in advance at the time of booking. Some special diet may incur a surcharge.
Medical - this information will be treated confidentially*
Do you have a medical condition or disability that might require special arrangements or facilities? (For examples, medicine allergy, learning disability, physical disability, pregnancy, regular medication). If yes, please tell us what this is and the type of support you would require.
Do we have permission to give the student Paracetamol, in case of emergency?*
Please note we are not allowed to provide any specialised or prescription medication. All students are asked to bring such medication with them.
Do you give permission for your child to receive emergency treatment at a UK hospital or medical centre, in case of accident or illness?*
Please be aware that medical treatment in the UK could incur a cost payable by the student. The National Health Service (NHS) only provides free medical care to EU students and certain other countries, and it does not cover dental treatment, glasses and prescriptions. The college will only send students for treatment in emergency situations. Non-urgent treatment should be carried out in the student’s home country.
Accommodation Preference

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