RIEES REGISTRATION FORM
We are delighted you are going to join us and would like a few more details about you. Please fill in this form.
Forename *
Your answer
Surname *
Your answer
Date Of Birth - dd/mm/yyyy *
Your answer
Gender *
Required
Address *
Including your postcode
Your answer
Contact Details
Home Phone No.
Your answer
Contact Details *
Mobile
Your answer
Contact Details
Email
Your answer
First Language
e.g. Urdu, English, French
Your answer
Level of English *
Not Spoken
Basic
Fluent
What is your disability /medical condition? *
Your answer
Special requirements *
Your answer
Medication (optional) *
Your answer
Do you use a walking aid or wheelchair? *
Mobility
Yes
No
Allergies/dietary requirements *
Your answer
Which of these do/did you attend? *
Mainstream School
Special needs School
Are you still in education? *
Required
Please tick your hobbies/interest *
Hobbies and Interests
Required
Things you would like help with/to learn *
Please tick the ones you are interested in
Required
RIEES REGISTRATION FORM
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