Apply to be restored to the student register

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.

Which register are you applying to restore to? ^* (required)

Previous GOC Number

Your full name, home town and practice address (if provided) will appear on the public register and may be available to third parties.

Title ^* (required)

First name ^* (required)

Last name(s) ^* (required)

What is your date of birth? ^* (required)

Email address ^* (required)

Primary contact address

Please provide details of your primary contact address.

Address line 1 ^* (required)

Address line 2

City / town ^* (required)

County ^* (required)

Postcode ^* (required)

Country ^* (required)

Is this your home or practice address? ^* (required)

Home

Practice

Telephone number ^* (required)

Additional telephone number

Please complete this form in one sitting to ensure all stages of the form get submitted to us.

Apply to be restored to the student register

About you

Before you begin

Primary contact address