Note – We are interested in your responses to the questions on this form for information only.
Places on the courses will be offered on a first-come first-served basis .
Name: Date of birth:
Email address:
School/college:
Give A Level Mathematics modules (with grades) you have already achieved:
Give A Level Further Mathematics modules (with grades) you have already achieved:
Does your school/college offer any support for the Oxford Entrance Test? If so please give details.
Is there anything else you think we should know about you?
The fee for the course is £50. Please give the name and address of the person at your school/college (or other) to whom the invoice for fees should be sent, should your application be successful (you should agree this before submitting this form). Please indicate the Purchase Order number if required.
Please return this completed form, by post or preferably as an email attachment, to
Bob Francis
9 Queens Close, Kingsteignton, Newton Abbot, Devon TQ12 3RD
Telephone: 01392 207412 Email: bobfrancis@furthermaths.org.uk
We will let you know the outcome of your application by return.