Cover Sheet - University of Sheffield

Faculty of
School/College Cover Sheet for Events
Sheffield Student Model UN
Thursday 12th November 2015 9.30am-3.30pm
Thank you for organising for your students to attend an event with The Faculty of Social Sciences Outreach
Team at the University of Sheffield. Please fill out this form to help us with our organising of the event.
Please remember that if you only have one or two students attending you can complete this information on
the back of their application form.
Please sign this form to confirm that the above application form is completed accurately and:
1. That we will receive all relevant information regarding disabilities, learning difficulties and allergies
2. Students have, or are on course for, a minimum of 5 A*-C grades at GCSE (with at least 3 grades B or
above and a minimum of Grade C in English and Maths)
3. If in Year 12 students are on course to get BBB or higher in their A Levels, or would be with the right
encouragement. This is due to the entry requirements at the University of Sheffield being ABB at
4. The students demonstrate commitment to their studies
5. All
If our events are oversubscribed we will be using information on the application form to priorities students
for places. This will include giving priority to students to students who are in the first generation of their
family to attend university and/or from backgrounds that are underrepresented in Higher Education
(i.e. pupils with a Disability and pupils who have been in care)”. In addition to this we may include
assessment of levels of deprivation of the applicant based on the home postcode provided. The University
will use a postcode analysis tool do this, e.g. Indices of Multiple Deprivation (IMD) and/or POLAR data, which
measures the progression rates to higher education from postcode areas.
Please help us by prioritising students who would benefit most from working with us – please make contact if
you’d like to talk about this.
Print Name:
Contact email:
The data collected here will be processed by the University of Sheffield in accordance with the Data Protection Act 1998 and held for an
extended period of time. We will not release data to anyone who is unauthorised. By submitting your reference, you are consenting to
the use of your data as outlined above.
If you do not wish to be contacted by the University of Sheffield about future activities for your students, please tick here ☐
Summary of details:
Total number of students
Total number of staff attending
We do not require supervision for students in Year 12 and 13 (unless it is a large group, please make contact
to discuss if unsure)
Name and contact details for accompanying staff
Print Name:
Contact email:
Contact phone:
Information about staff allergies or access requirements:
How will you travelling to/from the event?
 Minibus/taxi arranged by Faculty Outreach Team
 Own transport (requires Parking Permit supplied by Faculty Outreach Team)
 Public Transport
Other: _______________
Please return all application forms with this cover sheet by Thursday 22nd October 2015 to:
Victoria Large
Faculty Outreach Activities Assistant
Faculty of Social Sciences
ICOSS, 219 Portobello
Sheffield, S1 4DP
If you have any questions or require more information please just make contact:
[email protected] 0114 222 7138