Year 10 (KS4) Admissions for September 2018

How to apply:

All applications for entry in to Year 10 (KS4) in September 2018 are made directly with us at the UTC.

Please note: If you have already applied and wish to make a change to your application, please contact us by emailing information@utcmediacityuk.org.uk stating your name, year group applied for, and changes to be made.

Application Form

Student Details

Your Forename(s):

Your Surname:

Gender:  Male Female

Date of Birth:

Address
Address Line 1:

Address Line 2:

City:

County:

Postcode:

Home Telephone Number (no spaces):

Mobile (no spaces):

Email Address:



Education Details

Pathway choice:

Schools/colleges attended from ages 11 to 16 (and since if applicable) Please list name of school, location, start date and leave date

Please tell us about your career plans




Resident Status

Usual country of residence:
 England Other (please specify below):

Nationality:

Have you been a resident in the European Economic Area for the past 3 years?
 Yes No

If NO, give date of entry to the EEA:



Equal Opportunities Monitoring

To help the UTC monitor its Equal Opportunities policy, please tick the box that best describes your ethnic origin:



Additional Support Details

We want you to get the best from your course so please let us know how we can support you. If you have any learning support needs, disabilities or medical conditions, we can contact you in confidence to discuss the support available.

Please indicate below what support needs you have:
Please feel free to contact us on 0161 661 3947 to discuss further.
 Visual Impairment Hearing Impairment Disability Affecting Mobility Emotional/Behavioural Difficulties Mental Health Difficulties Moderate Learning Difficulty Severe Learning Difficulty Specific Language Impairment Dyslexia Dyscalculia Autism Spectrum Condition/Aspergers Syndrome



How did you hear about us?
Please tick all that apply:
 Google Search School/Guidance Adviser Careers event Newspaper Family/Friend Facebook Twitter Instagram Local Authority letter
Other (please specify):



Reference
We will contact your current school for this.



Statement

What skills would you like to develop?



Statement for Completion by Parent/Carer
Please completing this section you give this application your support.

Parent/Carer's full name

Address (if different from that of applicant):

Email

Telephone number

Mobile number

Our admissions policy can be access via our policies page.

Our entry requirements can be accessed here.

And finally, if you have any questions, please do get in touch with us.

If you would like an individual meeting to discuss your interest please email Sharon the Principal   principal@utcmediacityuk.org.uk