Online Application Form
APPLICANT INFORMATION
Name:*  
Applying for:  
Date of birth:  
Gender: Male  Female  
Phone:  
Post code:  
Current school:  
Current school address:  
Post code:  
Year / Level (Sept 2016):  
PARENT / GUARDIAN INFORMATION
Name of Parent:*  
Mobile No:*  
E-mail:*  
Home address:  
Post code:*  
HOW DID YOU HEAR ABOUT US?
 
EMERGENCY CONTACTS
In the event the parent/guardian cannot be reached, the school will call the person listed below. People listed should be individual(s) who can:
1) give permission to administer health care; 2) pick up your child if he/she is ill; or 3) give advice about caring for your child.
 
Name :  
Mobile No:  
E-mail:  
Relationship to student:  
ADDITIONAL INFORMATION
Information regarding learning difficulties or special educational needs, relevant to tuition:  
Other useful information:  
PAYMENT
I will be making a payment for £   
*Please note pupils applying for the one week course may only attend for the dates 8-12 August
Full payment of fees should be made with this application.
1. Cheques* payable to ‘BrightStars Learning’
Post to: Warren House, 2 Carrington Close, Arkley, Barnet, Herts, EN5 3NA
2.Online bank transfer*: BrightStars Learning, S/C 602477, A/C 25391941
*Email confirmation to info@brightstarslearning.co.uk
         
SUBMIT APPLICATION
 
   *I have read and agree to the Terms and Conditions.
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