Apply to be restored to the student register

Step 1 of 7

Before you begin

If you are transferring from one student register to another, or applying to a new register please complete our student transfer application form. If you have previously been registered as a student dispensing optician and now wish to train as a student optometrist (or vice versa) you will need to submit a full student registration application. Do not complete this form.

Only complete this form if you are restoring to the register that you used to be registered to. You must already be enrolled with an educational establishment for us to process your application.

Previous GOC Number

About you

Title *

First name *

Last name(s) *

What is your date of birth? *

Email address *

Primary contact address

Please provide details of your primary contact address.

Address line 1 *

Address line 2

City/town *

County *

Postcode *

Country *

Primary telephone *

Additional phone number

Practice details

What is the name of the practice?

Practice address line 1

Practice address line 2

Practice city/town

Practice county

Practice postcode

Practice telephone number

Do you wish to add another practice address? *

Yes
No

Additional practice address

Practice address line 1 *

Practice address line 2 *

Practice city/town *

Practice county *

Practice postcode *

Practice telephone number

Further practice addresses

If you need to add further practice addresses please email the registration team with the details. All practice addresses must be listed.