Year 10 (KS4) Admissions for September 2017

How to apply:

All applications for entry in to Year 10 (KS4) in September 2017 are made directly with us at the UTC.

(Our second round of applications have now closed so any applications made after the 24th of March 2017 will be placed on our waiting list.)

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:

Unique Learner Number (ULN):

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 Syndrove



Criminal Convictions, Cautions, Reprimands, Warnings etc.
Please see Guidance Notes.

Please give details of any prior criminal convictions, cautions, reprimands, warnings etc.



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



Reference
All applicants to year 10 have to supply a reference, and we will request this at the appropriate time. Your reference should be from your current or most recent school or college and include details on the following areas: predicted achievement or application to work tasks, motivation, general behaviour and relationships with others, attendance, punctuality, reliability and other relevant comments.



Statement

Please describe why you think UTC@MediaCityUK would be best suited for you in your intended career path, and what you hope to achieve from your time at UTC@MediaCityUK.



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