NTU Progression Year 10 Application Form NTU Progression is a programme of opportunities designed to support young people access and succeed at university. NTU Progression is open to young people in Year 10 or Year 12 at school or college. How do I apply? You must complete all sections of this form and return it to progression@ntu.ac.uk or post to: Nasser Latif, Shakespeare Villas, Shakespeare Street, Nottingham Trent University, NG1 4FQ. Information provided on this form will be used for the purposes of prioritisation and selection. Eligibility criteria To be eligible for the scheme, applicants must meet at least one of the below eligibility criteria: Be studying a vocational course such as a BTEC or an NVQ. Would be in the first generation of their family to have attended university (applicants with siblings who have/are attending university are eligible). Have had their studies disrupted by circumstances outside their control. Have been eligible for Free School Meals at any time in the last 6 years. Be in receipt of the 16-19 bursary. Have a disability. Have experience of living in Local Authority Care. Reside in disadvantaged neighbourhoods (once you have completed your application, we will inform you if you have met this criterion) What happens next? You will be contacted via email and informed of the outcome of your application. If successful, you will be sent further information. If you have any questions or require any further information, please contact Nasser Latif using the details below: Telephone: 0115 848 2817 / 07833046465 Email: progression@ntu.ac.uk Data Protection In order to ensure that our activities are effective and reaching the right people, we collect and analyse statistical information, including information about your ethnicity and disability statement. We may share the data held on this form with one or more of the following receiving organisations: partner Higher Education Providers in the East Midlands, the Higher Education Funding Council for England (HEFCE), the Universities and Colleges Admissions Service (UCAS), the Higher Education Statistics Agency (HESA), the Department for Education (DfE), Higher Education Access Tracker (HEAT) service subscribers, the National Data Service, your school or college, the school or college’s Local Authority East Midlands Widening Participation Research and Evaluation Partnership and the receiving organisations may then link data from this form to additional educational data about you (including DfE attainment data held on the National Pupil Database, UCAS records and/or HESA student records). We may access this data and use it to monitor the impact of our activities. Any personal data we collect will only be shared with the partners mentioned above, all research publications will be anonymised and the data will not be used for any other purpose. Data will be processed in accordance with the Data Protection Act 1998. For more information, please see http://www.legislation.org.uk/ or call 01509 223462. You are able to opt out of the information collected on this form to be used in the above mentioned research on Page 3. Page 1 Personal details If you are completing the form by hand, please use block capitals and black ink. Student Full Name: Date of Birth: D D M M Y Y Y Y Gender: Female Male Home Address: Home Postcode: Telephone number: Mobile number: Email Address: Student Disability (please tick): No known disability Deaf/hearing impaired Multiple disabilities Dyslexia or other Wheelchair user/mobility Autistic Spectrum Disorder learning need difficulty / Asperger’s Syndrome Blind/partially sighted Mental health difficulty Other disability Unseen disability Prefer not to say Chinese Black Caribbean White & Black African Bangladeshi Black African White & Black Caribbean Indian Other Black Background Other Mixed Background Pakistani White Other Ethnic Background Other Asian Background White & Asian Prefer not to say Student Ethnicity (please tick): Educational background of parents / carers Have any of your parents / carers been to university or taken a degree? Yes No Don’t know Parental / carer occupation - we would like to know the following information for research purposes only: Please think about which of your parents or carers currently living in your home earns the most money. What is their job? Free School Meal (FSM) Eligibility Have you been eligible for Free School Meals at any time in the last 6 years? Yes No Don’t know Prefer not to say Care history Are you living in or have any experience of living in Local Authority Care? Yes No Prefer not to say 16-19 Bursary Are you in receipt of the 16 – 19 Bursary? Yes No Prefer not to say Page 2 Education School Course Type: Year Group: GCSEs BTEC Other Qualification (please state) Subjects studied: Application Statement Please use this personal statement to tell us why you want to be a NTU Progression member and how you think you will benefit from being selected. Please do not exceed the space provided below. Declaration PLEASE COMPLETE THE INFORMATION BELOW Name: Date: (By writing your name you are consenting to your details being used to evaluate the effectiveness of our programmes, as explained on Page 1. You can opt out below). If you do not give your consent for the information collected on this form to be used in research mentioned on Page 1, then please tick this box Page 3