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Application for Year 12 2017/18

About you

Would you like to be contacted by email?*
Student's gender*

Emergency contact details

Your subject options

Please select one of the following qualification options:*

Please select the number of A-level options specified in your answer above, plus a reserve option.

Your previous education

 Subject and level (e.g. GCSE IT)YearPredicted resultActual result (if applicable)

Your future plans

Extra support for you

We provide a range of support for learners with learning difficulties, disabilities, medical and language support needs. This includes, and is not restricted to, support for mobility difficulties, visual impairments, deaf or hard of hearing, mental health difficulties, medial conditions such as epilepsy and specific learning difficulties such as dyslexia.

How would you prefer to be contacted?

Where did you find out about us?

Please tick all that apply:*

Information given on this form is personal data and is therefore subject to Data Protection Act 1998. Information you provide on this form may be passed to relevant educational agencies and Connexions, which are registered under the Data Protection Act 1998. Further information about data confidentiality is available upon request from student services. The UTC or Connexions may contact you to provide details and advise on further study and career opportunities.

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