CTS Education
Supplementary School Application Form (Evenings & Saturdays)
Address for CTS Education Supplementary School:
9 Magee Street, Northampton, NN1 4JT
Personal Information
I am registering
*
Select
Myself
Someone else
Will you be responsible for paying the fees?
*
Select
Yes
No
Student's First Name:
*
Enter Names as shown on passport
Student's Middle Name:
*
Enter Names as shown on passport
Student's Last Name / Surname:
*
Enter Names as shown on passport
Student's Contact Number:
*
Student's Email Address:
*
Student's Date of Birth:
*
Gender
*
Select
Male
Female
The student's address (state full address):
*
Post Code
*
The person responsible for the fees: First name(s)
*
The person responsible for the fees: Surname
*
The person responsible for the fees: Title
*
Select
Ms
Mrs
Mr
Other
The person responsible for the fees: Telephone Number
*
The person responsible for the fees: Email Address
*
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Other Details
Does the student have any disabilities or illnesses that would affect learning? (You will discuss this with our assessor during your interview with us).
*
Select
No disability or learning difficulties
Disabilities and learning difficulties
Learning difficulties
Disabilities
No information provided
Next of Kin / Emergency Contact Name and Surname
*
Relationship with Next of Kin / Emergency contact person
*
Next of Kin / emergency Contact Number
*
Next of Kin / Emergency Contact Email
*
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Tutorial Details
Subjects
*
Examination Board
*
Please tell us how you heard about CTS Education?
*
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Learner Agreement
In deciding upon your choice of learning program, you have considered the implications of the following: (Cost, Time, Commitment, Organisation, Ability)
*
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Yes
No
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