• Residential Programmes in Spain 2012

    Thank you for choosing to apply for a Glenn Hoddle Academy programme. Please complete the registration form below and click submit. You will then see a message confirming that your form has been submitted successfully with a link to take you back to the GHA home page. Please note that the submission of this form does not constitute a contract with GHA and does not guarantee the offer of a place which will be subject to availability. A member of the GHA team will contact you by email as soon as possible after the submission of your form to let you know the outcome of your application. If you have questions at any time, please email enquiries@glennhoddleacademy.com.

    Please note that the form below must be completed by the applicant’s parent or legal guardian. The only exceptions are where an applicant is over the age of 18, financially independent and living separately from his parents, in which case the relevant box confirming this must be ticked.

    It is important that you complete all fields that apply to you. Please check carefully the dates of the course for which you wish to register and then select the relevant option from the drop-down list under “Course” below.  If you wish to attend more than one course, please let us know this by typing in the details of what you would like to do in the “Other Courses” box.

    Please ensure that you have read our Privacy Policy before submitting your form. The Glenn Hoddle Academy is committed to ensuring that your privacy is protected. If at any time you do not wish to receive further information from GHA, please email info@glennhoddleacademy.com. Please tick the opt-in box below if you consent to your details being passed to selected third parties so that they can provide you with information about goods or services which they feel may be of interest to you. Details of those under the age of 18 will, of course, not be disclosed.

     Registration Form
       
    Student forenames (in full):
    Last Name:
    Preferred Name:
    Date of Birth (DD/MM/YY):
    Age:
    Over 18 (independent):
    Nationality
    (select country):
    Address Line 1:
    Address Line 2:
    Town/City:
    County/State:
    Postcode:
    Country:
    Home Phone:
    Mobile:
    Email:
    Course for which
    you wish to register:
    Other course(s) you
    would like to attend:
    Parent Title:
    Parent First Name:
    Parent Last Name:
    Relationship:
    Address same as
    the student:
    Parent Address Line 1
    (if different):
    Parent Address Line 2:
    Parent Town/City:
    Parent County/State:
    Parent Postcode:
    Parent Country:
    Parent Home Phone:
    Parent Work Phone:
    Parent Mobile:
    Parent Email:
    Preferred contact number:
    Where did you hear
    about GHA?:
    Would a future 3 month
    programme be of interest?:
    I consent to receiving
    marketing information:

     

     

    Verification Code:

    		  

    Please enter the verification code in the box above

Site: Yellowdot Design     ©2012 Glenn Hoddle Academy