Student Support Player Application Form

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Student Support Player Application Form - Christmas 2022

IMPORTANT NOTICE!

We will need to send emails to you shortly before or during the course. Please ensure that the email address you provide is one which you will be able to access during the period of the course.

Email *

Surname *

First name *

Gender *

Female

Male

Prefer not to say

Age at start of course *

Please enter in whole years only

Home postcode *

Please enter WITH a space - eg "YO1 1AZ"

Home telephone *

Please enter WITHOUT spaces - eg 01904123456.

Emergency telephone *

This should be a number where we can reach a member of your family in the event of an emergency during the course.

Home telephone

Other:

Health information *

Do you have any medical or behavioural condition which we may need to know about in order to ensure your safety and well-being during the course? eg. asthma, anxiety, phobia, allergies (including to basic first aid treatments) If YES, please give details in the next section of this form.

Yes

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