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Years 10-11 Free Tuition
Year 10-11
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Your Information
Do you consent to your child's photograph being taken and potentially used across promotional material taken at the year 10-11 tuition sessions? Please enter Y/N.
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First Name and Surname
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Gender
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Female
Male
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Date of Birth
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Phone Number
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Home Address and Postcode
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School
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Which day of the week are you registering for?
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Monday's at East Ham Library
Thursday's at the Renewal Programme
Both
Parent/Carer Information
Guardian Full Name
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Relation to You
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Guardian Contact Details (telephone and e-mail address)
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Do you have any special learning needs/disabilities? (if 'Yes', please specify)
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Do you have any dietary requirements/allergies? (if 'Yes', please specify)
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Equal Opportunities
What is your ethnicity? Please choose one box.
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White: English/Welsh/Scottish/Northern Irish/British
White: Irish
White: Gypsy or Irish Traveller
White: Other
Mixed/Multiple Ethnic Group: White and Caribbean
Mixed/Multiple Ethnic Group: White and African
Mixed/Multiple Ethnic Group: White and Asian
Mixed/Multiple Ethnic Group: Other
Asian/Asian British: Pakistani
Asian/Asian British: Bangladeshi
Asian/Asian British: Chinese
Asian/Asian British: Other
Black/African/Caribbean/Black British: African
Black/African/Caribbean/Black British: Caribbean
Black/African/Caribbean/Black British: Other
Other:
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