Year 10 (KS4) Admissions for September 2019

How to apply:

All applicationsĀ for entry in to Year 10 (KS4) in September 2019 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 admissions@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: MaleFemale

Date of Birth:

Address
Address Line 1:

Address Line 2:

City:

County:

Postcode:

Home Telephone Number (no spaces):

Student Mobile (no spaces):

Student Email Address:



Education Details

Options choice 1 (Please choose one):

Options choice 2 (Please choose one):

Options choice 3 (Please choose one):

Options choice 4 (Please choose one):

Current School

Do you know what career you want? If so please tell us here




Resident Status

Usual country of residence:
EnglandOther (please specify below):

Nationality:

Have you been a resident in the European Economic Area for the past 3 years?
YesNo

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 ImpairmentHearing ImpairmentDisability Affecting MobilityEmotional/Behavioural DifficultiesMental Health DifficultiesModerate Learning DifficultySevere Learning DifficultySpecific Language ImpairmentDyslexiaDyscalculiaAutism Spectrum Condition/Aspergers Syndrome



How did you hear about us?
Please tick all that apply:
Google SearchSchool/Guidance AdviserCareers eventNewspaperFamily/FriendFacebookTwitterInstagramLocal Authority letter
Other (please specify):



Reference
We will contact your current school for this.



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

If you would like an individual meeting to discuss your interest please email Ruth Bradbury, the Principal, onĀ  ruth.bradbury@utcmediacityuk.org.uk