Recovery College registration form Recovery College Registration Form PERSONAL AND CONTACT DETAILS Are you a returning student? Are you registering to support someone on the course? Employment status Employed Unemployed/Retired Student Do you want to be added to our mailing list for future prospectus?yesnoWould you like to receive further information on courses relating to those you have attended?YesNoName* First Last Date of Birth* Address* Street Address Address Line 2 Town/City Postcode Please include a contact telephone number:Telephone noMobileEmail Enter Email Confirm Email Would you like to recieve Zoom codes via email or text?* Email Text CONTACT DETAILS IN CASE OF EMERGENCYName First Last Contact numberCOURSE DETAILSCourse 1*Date(s)VenueCourse 2Date(s)VenueCourse 3Date(s)VenueCourse 4Date(s)VenueCourse 5Date(s)VenuePlease outline in brief, any difficulty which may make it hard for you to attend or fully benefit from any courses you have registered for. This could connect to mental health learning difficulties or a disability issue (including reading and writing).How did you hear about the Recovery College? Keyworker GP Search engine (goggle etc.) Facebook Trust intranet/broadcast emails Word of mouth Other UntitledSection BreakPhoneThis field is for validation purposes and should be left unchanged.