Please complete the following student questionnaire providing as many details as possible. This will help us know more about you and about any dietary requirements or special needs you may have. GENERAL DETAILSStudent Name* First Last Preferred Name Student Email* Enter Email Confirm Email Student Passport Number* T-Shirt Size*XSSMLXLXXLUpload PhotoMax. file size: 128 MB.PERSONAL DETAILSThis section should be filled by parents and students. Please contact us directly with anything confidential.Do you have any phobias, fears or allergies?* Yes No If "Yes", please provide detailsAre there any circumstances, issues or personal / family issues that we should know about or that may affect you while at LITE Regal?Please be assured that all information will be handled with great care and confidentiality.Do you have any dietary requirements we should be aware of?* Yes No If "Yes", please provide detailsWill you follow any religious festivals or practices?* Yes No If "Yes", please provide detailsMEDICAL DETAILSAre there any circumstances (physical, mental, emotional) in your medical history that you feel we should be aware of?* Yes No If so, please specifyPlease detail any medication you will bring / take during the summer schoolPlease detail specific use of any prescription medication you will be bringing with youName and address of family doctor*Doctor Telephone*In case of an emergencyACADEMIC DETAILSPlease note that these questions aim to give us an indication of your academic experience, ability and goals.School year which you will enter after summer* Do you have any learning difficulties we should be aware of?* Yes No If so, please specifyACCOMMODATION DETAILSDo you prefer to share a twin room with another student?* Yes No If Yes please provide below name of the person / friend you would like to share the room with. If you would like to share room with another student please provide below your preferences.ACTIVITIES DETAILSAre you a confident swimmer?* Yes No Which activities would you be interested in?*Please note that this is just to give us an idea of your interests Hiking Ultimate Frisbee Swimming Basketball Soccer / Football Yoga / Pilates Zumba Volleyball Punting Sightseeing Arts University Admissions Other If "Other", please specifyAre there any reasons why you cannot or may choose not to take part in any of our sporting or evening activities?* Yes No If "Yes", please specifyDo you play any musical instrument?*We would encourage students who play musical instruments to bring them if they are easy to travel with and they are interested in being involved in a summer school band or for the talents shows etc. Yes No If "Yes", please specifyPlease let us know what you wish to gain from this summer experience and any additional requirements / requests or suggestions you would like to make.TRAVEL DETAILSPlease visit our APPLY page to apply for transfer service. Alternatively please follow this link: https://www.literegal.co.uk/travel-form/Does the student require visa?* Yes No How will the student be arriving*PlaneDrop OffOtherOtherPlease specify other travel arrangementsArrival Date* DD slash MM slash YYYY Arrival Time* : Hours Minutes How will the student be departing*PlaneDrop OffOtherOtherPlease specify other travel arrangementsDeparture Date* DD slash MM slash YYYY Departure Time* : Hours Minutes Additional Information