This form is for new sign up for our university package ONLY.

Our new student registration fee is £180 and the annual fee for the university package is £490.

Please ensure you have filled out the information as accurately as possible.

Main Email Address

Student Details

Last Name/ Surname

First Names/ Given Names

Date of Birth

Nationality

Sex

Male

Female

Prefer not to say

Other

If other, please specify:

Which school will you be attending?

Which year will you be going into?

When will you start your course?

Parents Details

Father's Full Name

Mother's Full Name

Full Home Address

Telephone Number (inc area code)

Secondary telephone number

Parent's email

Languages spoken at home

Parents' level of English for communication purposes

Any other siblings studying in the UK?

If so, which school?

Which guardianship company?

Are there any medical conditions we should be aware of?

How did you hear about Belgravia?

Name of consultant (if you were referred by an agent)

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Your Signature

Thanks for your payment!