Apply Online - A Levels Easter Revision | Lite Regal International College

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STUDENT DETAILS
Name*
First Last
Gender*
- Male
- Female
Date of Birth*
Nationality*
Email*
Enter Email Confirm Email
Phone*
Mobile*
Address*
Your marked exam papers will be sent to this address.
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Do you have any specific learning difficulties or access arrangements?*
If YES, please provide details.
Do you have any health issues or dietary requirements we should be aware of?*
If YES, please provide details.
How did you hear about us?
- I am returning student
- Brother / sister attended
- Friend
- Agent
- Teacher
- Search Engine
- Other

COURSE DETAILS
You can select one subject for each morning and afternoon. If you wish to study a subject more intensively you can select to study this subject in the morning as well as afternoon.
Session 1 Subjects: Mon 1st April - Fri 5th April
Select your morning subject*
Please select none if you do not wish to study on these dates.
Select your afternoon subject*
Please select none if you do not wish to study on these dates.
Session 2 Subjects: Mon 8th April - Fri 12th April
Select your morning subject*
Please select none if you do not wish to study on these dates.
Select your afternoon subject*
Please select none if you do not wish to study on these dates.
Session 3 Subjects: Mon 15th April - Fri 19th April
Select your morning subject*
Please select none if you do not wish to study on these dates.
Select your afternoon subject*
Please select none if you do not wish to study on these dates.
Exam Boards, Level and Further Details
Please write for each subject you have selected the following details: Exam Board, Level (AS / A1, A2), areas on which you would like to concentrate.*
Do you require accommodation?*
No. of weeks you require accommodation for*
Additional Information
Please tell us the areas you would like to concentrate on for each subject.
Where Would You Like To Study*
Name Of Current School*
Head Of Year
School Address

PARENT/LEGAL GUARDIAN CONTACT DETAILS
In order to ensure the well being of all students, LITE Regal must have the contact information for at least one parent or legal guardian of each participant.
Name*
First Last
Home Phone
Mobile Phone*
Email*
Enter Email Confirm Email
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Cardholder's Name*
First Last
Cardholder's Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email address for payment confirmation*
Confirmation of your payment will be sent to this email address.
Enter Email Confirm Email
Total Amount Payable
Please note once you press submit you will be redirected to a secure page where you can enter your card details.
£ 0.00

STUDENT DETAILS