Enrol at MLC

Please complete the enrolment form below

Step 1 of 4

Choose Your Centre*

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About You
The person completing this form. This section is to be completed by those applying to study at MLC and who are over 18 or a parent/carer for those under 18.
Name*
First Last
Contact Phone Number*
Email Address*
Address*
Street Address Address Line 2 City County Postcode Country

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About The Student
Over 18s duplicate the information above or tell us about the youngster that you are registering.
Student Name*
First Last
Knowing the age of the student is very important as we have a duty of care to everyone who studies at MLC. Your information is private and will remain so.
Date of Birth*
DD slash MM slash YYYY
Gender*
Name of Current Day School*
Medical or Special Requirements
These details are very important as we have a duty of care to everyone to studies at MLC Academy. Your information is private and will remain so. If none, please type 'none'.
Medical or Special Requirements*
Emergency Contact
Please supply emergency contact details.
Emergency Contact's Name*
First Last
Emergency Contact's Phone Number*
Emergency Contact's Address*
Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

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I give my permission for my image/video to be captured and used internally by MLC*
I give my permission for my image/video to be captured and used internally by MLC. This is for your protection. Your image may be captured by CCTV.
- Yes CCTV
I give my permission for my image/video to be captured and used for external marketing purposes
I give my permission for my image/video to be captured and used for external marketing purposes.
- Yes Marketing
Terms and conditions*
I certify that by submitting this form that I am 18 years or older and agree to the terms and conditions (published by MLC).
- I agree T&C
Name
This field is for validation purposes and should be left unchanged.

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Questions?

We’re happy to help with any queries you may have