MAT registration form This form is designed as an aid for centres making entries via the Admissions Testing Service Entries Extranet. It will NOT be accepted as an entry by the Admissions Testing Service. Please refer to the Instructions for completing the registration form which appear later in this document. 1. CENTRE DETAILS Centre name: Centre number: Telephone number: (including country code) Address: Fax number: (including country code) Email address: Contact name: 2. CANDIDATE DETAILS Family name: Gender: First name(s): Male UCAS ID: - / Candidate’s email: Candidate’s address: Universities applied to Date of birth: (dd/mm/yyyy) Female Telephone number: Course code College code College name (if applicable) / 3. ACCESS ARRANGEMENTS Not applicable Maximum of 25% extra time Braille question papers Supervised rest breaks Modified enlarged A4 question paper Use of laptop Reader Other (please state in box below) Scribe Unmodified A3 question paper and answer sheet Reason for Access Arrangement request (evidence, statement from school/doctor etc.) 4. CANDIDATE’S SIGNATURE AMB DATA PROTECTION NOTICE / CONSENT Please note that by registering and taking the Mathematics Admissions Test (MAT), you are agreeing that data provided as part of the entry or admission process may be passed to the Admissions Testing Service, the University of Oxford and Imperial College London, and also that your data may be used for research purposes. If you obtain a place for a course where your MAT result was used in the admissions process, you also agree that the University of Oxford and Imperial College London may supply the Admissions Testing Service with data about your results in subsequent assessments whilst you are studying at the University of Oxford or Imperial College London for the purposes of on-going predictive validity studies. We store personal data securely and will ensure that if your data is used in any publications or research that it is used anonymously. You can withdraw your consent for your data to be used in the evaluation exercise by requesting this in writing from the University of Oxford or Imperial College London. CENTRE’S TERMS* SIGNATURE ____________________________________________________________________ DATE ______________________ *Centres should update this part of the form to suit their centre’s local terms. PLEASE RETURN THIS FORM TO YOUR CENTRE. THIS REGISTRATION FORM SHOULD NOT BE RETURNED TO THE ADMISSIONS TESTING SERVICE. ALL ENTRIES FOR MAT MUST BE MADE BY REGISTERED CENTRES VIA THE ADMISSIONS TESTING SERVICE ENTRIES EXTRANET BY 18.00 BST ON 15 OCTOBER 2015. Instructions for completing the registration form Candidate details Please give your name, gender and date of birth exactly as provided to the universities or UCAS. Please select the universities in the list that you have applied to, and give the course code that you are applying for: Institution Course Codes University of Oxford (O33) Imperial College London (I50) G100 Mathematics GG14 Mathematics and Computer Science GV15 Mathematics and Philosophy GG13 Mathematics and Statistics G400 Computer Science IV15 Computer Science and Philosophy G100 Mathematics (3-year course) G103 Mathematics (4-year course) G125 Mathematics (Pure Mathematics) GG31 Mathematics, Optimisation and Statistics G104 Mathematics with a Year in Europe G1F3 Mathematics with Applied Mathematics/Mathematical Physics G102 Mathematics with Mathematical Computation G1G3 Mathematics with Statistics G1GH Mathematics with Statistics for Finance For Oxford University, please give the College name from the following list: Open application OPEN Balliol Brasenose Christ Church Corpus Christi Exeter Hertford Jesus Keble Lady Margaret Hall Lincoln BAL BNC CCH CCC EXT HTF JES KBL LMH LIN Magdalen Mansfield Merton New College Oriel Pembroke Queen’s St Anne’s St Catherine’s St Edmund Hall St Hilda’s St. Hugh’s MAG MAN MER NEW ORL PBK QNS STA STC SEH SHI SHU St. John’s St Peter’s Somerville Trinity University Wadham Worcester STJ STP SOM TRI UNI WAD WOR Please consult the University of Oxford website to ensure that your chosen College is accepting applications for your chosen course. Access arrangements If you are normally allowed access arrangements such as extra time or enlarged papers to take public examinations, please note this on your registration form. Please see section 3 of this form for a list of access arrangements available. If your access arrangement is not listed, please provide more detail of it on the registration form. It is your responsibility to make your centre aware of any access arrangements you may need. Requests for modified question papers (Braille, enlarged paper etc.) must be received by 30th September 2015. Further information relating to the MAT can be found at www.admissionstestingservice.org/mat