Change of Details Form

It is important that Edurium has up-to-date contact and emergency details for every student. Please complete this form if your contact details, your child’s details, or emergency information changes. This ensures we can always communicate effectively and keep your child safe.

Change of Details Form

Current Student Information

Full Name of Student

Current Year Group

3456

Preferred Centre

WhittonTwickenham

Details to be Updated

Parent/Guardian Name

New Address

New Contact Number

New Email Address

Other

Emergency Contact Update

New Emergency Contact Name

Relationship to Student

MotherFatherGuardianOther

New Emergency Contact Number

Consent

I confirm that the information provided in this form is accurate and should replace the previous details held by Edurium.

Parent/Guardian Signature

Date

MM slash DD slash YYYY