The Recovery College registration form Student declaration Note: Questions marked by * are mandatory Recovery College Student Charter and Code of Conduct I agree the information given is correct to the best of my knowledge. I agree to the Recovery College Student Charter & Code of Conduct and understand that online violence and abuse towards other students and staff will not be tolerated. I understand the information provided in this form will be treated as confidential; however, it is used for statistical data purposes for The Recovery College. Please see our Privacy Notice here. Student details *This is a mandatory field. Name *This is a mandatory field. Date of birth DD 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 MM Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec *This is a mandatory field. Address *This is a mandatory field. Postcode *This is a mandatory field. Mobile number Telephone number *This is a mandatory field. Email *This is a mandatory field. Borough Please Select An Option CamdenIslingtonOther The Recovery College runs courses open to residents of Islington and Camden, as well as anyone with a professional, family or carer connection with either borough. Emergency contact details *This is a mandatory field. Emergency contact name *This is a mandatory field. Emergency contact number Relationship to you * Spam Guard: Is a stop sign red or blue? You are here: Page 1 of 4
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