UKSA Residential Booking Form
Please complete this booking form and submit it, along with your £100 deposit via BACS payment by 1st May 2018 in order to secure your place.
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Name *
Current School *
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Address *
Postcode *
Student Email Address *
Student Phone Number *
Parent/Carer Name *
Parent/Carer Address (If different from above)
Parent/Carer Email Address *
Parent/Carer Phone  Number *
I have applied/am a student at UTC Portsmouth *
Required
Are any of your immediate family in the Royal Navy or Royal Marines? *
I have read and agree to the Terms and Conditions (attached on original email) *
Required
I have paid the £100 fee (cheques should be sent to the UTC addressed to "UKSA WEEK") *
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