PERSONAL DETAILS

Male Female

First Names

Surname

Nationality

Date of birth

Telephone

Full address
incl postcode

Mobile

Email

Fax

COURSE DETAILS Please tick the centre you wish to attend.

Residential Programmes

Location

School/College

Room Type

Bognor

University of the Chichester

Ensuite

Select single

Bognor

University of the Chichester

Standard

Select single

Bristol

University of the
West of England

Ensuite

Select single

Cirencester

Royal Agricultural College

Standard

Select single twin

Egham

University of London

Ensuite

Select single

Edinburgh

Jewel & Esk College

Standard

Select twin

Guildford

University of Surrey

Standard

Select single twin

Horsham

Christ's Hospital School

Standard

Select single twin

London

Goldsmiths' College

Ensuite

Select single twin

London

Goldsmiths' College

Standard

Select single twin

London

Greenwich -
College & Family Stay

Ensuite

Select single

London

Greenwich -
College & Family Stay

Standard

Select twin

Oxford

Brookes-Harcourt Hill

Standard

Select single twin

Winchester

Sparsholt College

Ensuite

Select single twin

York

The Mount School

Standard

Select Multi bed

Start Date

For
weeks

Finish Date

HEALTH
Do you suffer from any of the following (tick for yes)

Allergies

Dyslexia

Anorexia

Epilepsy

Asthma

Mental Illness

Bulimia

Physical disability

Are you a vegetarian? (tick for yes)

Do you have any special dietary requirements? (tick for yes)

If you have answered yes to any of the above or have any other medical condition, please give details below, including details of treatment

Do you authorise ISIS to take action in event of a medical emergency?
YES NO

NEXT OF KIN

Name of next of kin

Telephone

Full Address
inc. postcode

Mobile

Email

Fax

ARRIVAL & DEPARTURE DETAILS

Do you require a transfer from the airport YES NO

Arrival Date

Arrival Time

Departure Date

Departure time

Arrival Airport

Flight number

Departure Airport

Flight number

DECLARATION
While ISIS will take every action to ensure the safety of students, we ask students and parents to read the following carefully.

• ISIS Education and Travel take no responsibility for medical emergencies arising from non disclosure of current medical information
• By enrolling the student on the course, the parents/guardians are granting permission for the student to attend all activities organised by ISIS
• ISIS accepts no responsibilty for money or personal belongings which have not been given to appointed staff for safekeeping
• By registering for the course the student and parents or guardians accept to comply with ISIS's regulations and English and Scottish law.