Application Form
VENUE-1:
(mixed)

Stoke Newington Library
182 Stoke Newington Church St
N16 0JL

VENUE-2:
(women only)

Cypriot Community Centre
Earlham Grove, Wood Green
N22 5HJ

Personal Details
Full Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Marital Status *
Your answer
Ethnicity *
Required
Gender *
Required
Mobile Number *
Your answer
Email Address *
Your answer
Your Address
Home Number *
Your answer
Street Address *
Your answer
City *
Your answer
Postcode *
Your answer
Your English level
What is your English level? *
If other, please state:
Your answer
When do you want to start?
Women can register for both of the venues while men can only register for the course at Stoke Newington Library.
Select Location(s) *
Required
Choose a day *
Required
Choose a start date *
Notes
Additional Comments
Your answer
Terms and Conditions
By registering for the Creative English programme as a ‘Learner’, you agree to all terms and conditions stated below.

This programme is completely free so there won’t be any charges unless you want to purchase extra resources from our centre.

Learners are expected to attend a minimum of 20 hours unless there is a valid excuse.

First Aid will be administered by qualified members of staff if necessary.

We will take photographs and videos during the sessions to introduce and promote Creative English programme through our social media, brochures and website.

Learners are liable for any damage they cause to the equipment and the premises.

All absences should be reported by phone (020 3371 7181) to us prior to the registered sessions.

Data Protection Statement

The information which you give when completing this form will be used in accordance with the Data Protection Act 1998 and GDPR regulations for the following purposes: to enable the organisation to create an electronic and paper record of your application; to enable the application to be processed; to enable the organisation to compile statistics, or to assist other organisations and programme funders to do so, provided that no statistical information that would identify you as an individual will be published. The information will be kept securely and will be kept no longer than necessary.

Do you agree to all terms and conditions. *
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