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Connections UK Guardianships Ltd

Aspire Centre, Yarmouth Road, Lowestoft, Suffolk,NR32 4BF United Kingdom.

+44(0)1502 580203  or  +44(0)7517 056969

info@connections-uk.com

APPLICATION FORM

STUDENT DETAILS

Family Name: ……………………………………………………..……………………Male / Female

First Names: ……………………………………….Known as: ……………………………………..

Nationality: ………………………………………….Date of Birth:  …………………………………

Home Address:

…………………………………………………………………………………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………

Home Telephone: ………………………………….Home Fax: ……………………………………..

Mobile Telephone: ………………………………………………………………………………………

Student’s Email: …………………………………………………………………………………………

FAMILY DETAILS

Father's Name: …………………………………….Nationality: ……………………………………..

Father's Occupation: ……………………………… Does Father speak English?  Yes / No

Mother's Name: ……………………………………Nationality: …………………………………….

Mother's Occupation: ………………………………Does Mother speak English?  Yes / No

Parents’ Email: …………………………………………………………………………………..……

Do you have brothers or sisters? If so, please give name(s) and details……………………….

…………………………………………………………………………………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………

Do you have any relatives already living in the UK?  If so, please give names, addresses and telephone numbers……………………………………………………………………………………..

…………………………………………………………………………………………………………………………………………………………………………………………………………………………

……………………………………………………………………………………………………………

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