Revision Courses Enrolment Form - January 2010

9th/10th | 16th/17th | 23rd/24th | 30th/31st

We accept the following payment methods:

Visa
Visa Electron
Mastercard
Maestro
JCB
Switch
Paypal

Please use a separate booking form for each student

Please complete all fields marked by the asterisk

 

Step 1 of 6 - Student Details:

   
Forename:
*
Surname:
*
Gender:
*
Date of Birth:
Day
Month
Year
*
 
Address Line 1:
*
Address Line 2:  
City / Town:
*
Postcode:
*
Home Phone:
*
Mobile Phone:  
School:
*
Contact Email:
*

 

Step 2 of 6 - Parent/Guardian Details:

   

Surname:

*
Forename:
*
Address Line 1 (if different from above):  
Address Line 2:  
City / Town:  
Postcode:  
Home Phone (if different from above):  
Mobile Phone:  
Email (if different from above):  
Please tick where you FIRST heard about us:
We have used The Knowledge Gap before Friend / Family
Search engine Radio advert
*
Yellow Pages Yell.com
Leaflet in letterbox Newspaper or Other (please specify below)
 

 

Step 3 of 6 - Course Details:
Please list the subjects you would like to study and select the appropriate level, exam board and predicted grade
FOR EACH WEEKEND, PLEASE ONLY COMPLETE EITHER AS LEVEL OR A2 LEVEL SECTIONS, NOT BOTH

AS Level Weekends
Weekend Number
1 (9th / 10th January)
2 (16th / 17th January)
3 (23rd / 24th January)
4 (30th / 31stJanuary)
 
AT LEAST ONE WEEKEND REQUIRED
Subject
Exam Board
Predicted Grade
Syllabus Number (if known)
     
A2 Level Weekends
Weekend Number
1 (9th / 10th January)
2 (16th / 17th January)
3 (23rd / 24th January)
4 (30th / 31stJanuary)
 
AT LEAST ONE WEEKEND REQUIRED
Subject
Exam Board
Predicted Grade
Syllabus Number (if known)

 

 

Step 4 of 6 - Calculate Costs:

 

Press the button below after filling in your course details to calculate your course costs

 
   
Your total amount payable is: £
Your minimum deposit payable is: £
   

We accept the following payment methods:

Visa
Visa Electron
Mastercard
Maestro
JCB
Switch
Paypal
 

Step 5 of 6 - Agree and Submit:

I have read, fully understand and accept The Knowledge Gap's Terms & Conditions
and I agree to the costs payable in the boxes above

PLEASE REVIEW ALL OF YOUR DETAILS CAREFULLY BEFORE SUBMITTING THE BOOKING FORM

Terms and Conditions - Please read carefully: