Student's given name(s):
 *
 

Student's family name:
 *
 

Student's preferred name:
 *
 

Student's date of birth:        Student's sex:
  01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 1920s 1930s 1940s 1950s 1960s 1970s 1980s 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 19xx *                  Choose Female Male *
 

Student's previous Education   

Home Educated Some Home Ed / some Attended Schooling Attends/-ed School Educated outside UK Student has not been educated in English Has had unsettled education Has missed significant amounts of schooling Has moved a lot Not Answered

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Student's Needs from Briteschool

Would like to attend Full-time, Secondary classes Would like to attend Full-time IGCSE classes Would like to attend Part-time Secondary Would like to do 1 - 4 IGCSEs Would like to attend Primary School Would like to some Primary assistance Would like to do the ECDL Student has Special Needs Student may require English Language assistance Would like 1-to-1 tutoring Would like to join small tuition groups Would like to try out Briteschool Would like more information Not sure Not answered

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Notes:
 Please make brief notes here about the student. More detail will be required in the full application form which will be posted to European addresses, and emailed to the Rest of the World.
     

Parent / guardian contact details: (for students under eighteen years of age)

Name of student's primary guardian: Choose one Miss Ms Mr Mrs Mr and Mrs Mr and Ms Dr Drs other M  
 *
Address
 
Address

Address

Post Code / City / Country
*
Telephone 1
 *
Mobile / Cell phone 1

Please re-enter primary telephone contact number

Email 1 (an alternate email may be included here as well)
*

* Please re-enter primary email 1 address
*

Notes:
Please state here the relationship of the carer to the child - parent, grandparent, guardian, etc. - and any other notes that might be material when communicating with the carer (for example, the carer is hard of hearing).
 

Name of student's secondary guardian: Miss Ms Mr Mrs Mr and Mrs Mr and Ms Dr Drs other M  

Address 2

Address 2

Address 2

Post Code / Country 2

Telephone 2

Mobile / Cell phone 2

Email 2

Notes 2
If there are two primary guardians living at separate addresses and requiring separate but equal communications from Briteschool, please indicate this here. Please also state the relationship of this guardian to the child - parent, grandparent, guardian, etc.

Student's Operating System         Preferred Browser

Not Answered Windows XP Windows 2000 Windows 98SE Windows Other I think Windows but I'm Not Sure Mac OS-X Mac Other Mac but Not Sure which OS Not Sure Linux or Other What is an Operating System ?            Internet Explorer Firefox Safari Opera Netscape Other Not sure Not answered

Who filled out this form:       Is this person over 18 years old ?

ParentGuardian1 ParentGuardian2 Student OtherRelative Other NotAnswered                    tick if the person who submitted this form is over 18

How did you hear about Briteschool?

  Search Engine Word of Mouth The Sunday Post article Telegraph Weekly Telegraph Saturday Education Town Crier Article Town Crier Ad Sur In English Advert Home-education.org website Gomilpitas US website Education Otherwise Yell.com / Yellow Pages Newspaper Article By clicking on a Banner Talk in a Forum Advertisement Internet Article or Discussion Internet Search TV coverage Radio Article RosieAroundTheWorld ChannelM Manchester Metro News Manchester Evening News HE EO Other not specified press CTRL (COMMAND for Mac) to choose more than one

Briteschool and BriteNiteSchool will not pass on your contact details to other organisations.

I agree that Briteschool can register the details above, and may contact me again about its products or services:*

You will be able to opt out of receiving Briteschool communications at any time.

Note: if the box is empty, we will hold your contact details in accordance with the Data Protection Act 1998 (UK) and respond to the above contact only - with a complete Registration Form by post (or email outside the EU).  This is in order to comply with Electronic Privacy and  Data Protection regulations in the UK and Europe.