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Student Information

First Name^*

Last Name^*

Student Email

Student Contact

We may need to contact your child directly incase of technical issues during class or assessment.

Date of Birth ^*

Gender^*

Nationality ^*

Is English the students native language?^*

Other languages spoken (if any)

Pupils full address^*

Student Passport or National ID^*

Students Birth Certificate^*

Does the student have any disabilities or learning difficulties?^*

If yes, please provide details

Studying at Eton Academy Tuition Centre

Anticipated Entry^*

Subjects^*

From which country will the student be studying from^*

Primary Parent or Guardian Information

Relationship to the student^*

Are you the legal guardianship of the student?^*

Title^*

First Name ^*

Last Name ^*

Email^*

Phone Number^*

Full Address^*

Native Language^*

Do you reside at the same address as the student?^*

Secondary Parent or Guardian Information

Relationship to student

Are you the legal guardianship of the student?

Title

First Name

Last Name

Email

Phone Number

Full Address

Do you reside at the same address as the student?

Educational Background

Current school

Language studied in

Recruitment Centre

Which centre did you register through?^*

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