Rocket Learning

Summer Program Application Form

Complete the form with the student and family information for the international summer program.

Destination

1. Student Personal Information

First Name *

Last Name *

Date of Birth *

Passport / ID Number

Nationality

Address

City & Postal Code

Student Email *

Student Phone

1.2 Student Documentation

DNI / National ID Number

DNI Date of Issue

DNI Expiry Date

Passport Number

Issuing Country

Passport Date of Issue

Passport Expiry Date

2. Family Information

Parent/Guardian 1 Name *

Phone

Email *

Parent/Guardian 2 Name

Phone

Siblings (optional)

Siblings Phone

Siblings Email

3. Medical Information

Allergies / Alergias

Other chronic conditions

Psychological / emotional considerations

Special dietary requirements

Medications during the program

4. Observations / Notes

5. Authorisations

Image authorisation

Sí

Transport authorisation

Sí

Emergency medical authorisation

Sí

Parents / Legal Guardians Signatures

Father / Legal Guardian Name

Signature

Date

Mother / Legal Guardian Name

Signature

Date

6. Student Letter (mandatory)

Please write a short letter introducing yourself, your family, your interests and why you want to join this summer program *

He leído y acepto la Política de Privacidad y Protección de Datos.

Responsable: Rocket Learning. Finalidad: gestionar la participación en el programa internacional y responder a la solicitud enviada.