Apply for Immersion Programme

UK2LEARN IMMERSION PROGRAMME STUDENT PROFILE FORM

Please complete all 7 pages and then click submit on the final page when you are happy

How did you find out about UK2Learn? *

YOUR PERSONAL INFORMATION

Name: *

First

Last

Short name/nickname

Date of birth: *

Age: *

Gender: *

Nationality: *

Mobile phone number: *

E-mail address: *

Home address: *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Religion:

How many brothers and sisters do you have? *

First language: *

Other languages:

What level do you think your English speaking and listening is:

What level do you think your English reading and writing is:

Have you been to the UK before?

What are your hobbies and talents? *

What are your favourite subjects at school? *

What else can you tell us about your family and life?

Profile picture upload:

Click or drag a file to this area to upload.

Please upload a recent picture of yourself so that we can see your face clearly

INFORMATION ABOUT PARENT(S) AND/OR LEGAL GUARDIAN

1st parent or legal guardian

What is your relationship to the applicant? *

Name: *

First

Last

Occupation: *

Do you live at the same address as the applicant? *

Address: *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Home phone number:

Work phone number:

Mobile phone number: *

24 hour emergency number: *

E-mail address: *

2nd parent or legal guardian

What is your relationship to the applicant?

Name:

First

Last

Occupation:

Do you live at the same address as the applicant?

Address:

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Home phone number:

Work phone number:

Mobile phone number:

24 hour emergency number:

E-mail address:

INFORMATION ABOUT ANY UK CONTACTS

Do you have a contact in the UK?

For example, a family member or friend

Address: *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone

Guardianship Services and Educational Programmes
for International Students Studying in the UK.

UK2LEARN IMMERSION PROGRAMME STUDENT PROFILE FORM

YOUR PERSONAL INFORMATION

YOUR PASSPORT DETAILS

YOUR MEDICAL INFORMATION

YOUR INSURANCE

YOU AND YOUR FAMILY

YOUR SCHOOL

INFORMATION ABOUT PARENT(S) AND/OR LEGAL GUARDIAN

1st parent or legal guardian

2nd parent or legal guardian

INFORMATION ABOUT ANY UK CONTACTS

PARENTAL CONSENT

1st parent or legal guardian

2nd parent or legal guardian