Uni Genius Academic Tutoring Scheme 2014-15
Uni Genius seeks to support disadvantaged, talented young people at schools around London to go
on to study STEM (Science, Technology, Engineering and Maths) at university.
As Academic Tutors, you will help our students achieve the grades that they need to make
competitive applications to the very best institutions. Please complete this application form to be
considered as an Academic Tutor for Uni Genius.
If you are completing a paper application, please write in BLOCK CAPITALS.
Personal Information
Full Name
Mobile telephone number
E-mail Address
Gender
DOB (dd/mm/yyyy)
Address
Post Code
Education
If you are a student still in Higher Education, please provide the following details:
HE Institution (e.g. UCL)
Course studied (e.g. BSc Chemistry)
Year of Study
Please provide details of any educational qualifications that have been achieved.
Subject
Qualification Level (e.g. ALevel/BSc/MSc etc.)
Grade/Classification (if
completed)
Uni Genius Academic Tutoring Scheme 2014-15
Tutoring
As tutors, you will be facilitating learning for Year 12 and 13 students on a one-to-one basis in their
AS and A2 exams, in the various STEM subjects. There will not be an expectation on you to prepare
and teach ‘lessons’, only to be available to provide support to students with their studies. There will
however be a degree of freedom for you to plan and deliver appropriate activities if you have any
specific ideas that you would like to explore.
Please indicate below which subjects you would be comfortable providing support in, and up to
what level:
Maths
Subject
A Level
☐
Level
AS Level ☐
Further Maths
A Level
☐
AS Level ☐
Chemistry
A Level
☐
AS Level ☐
Physics
Biology
A Level
A Level
☐
☐
AS Level ☐
AS Level ☐
Economics
A Level
☐
AS Level ☐
Please state below any other subjects not listed above that you would be willing to support, and up
to what level.
Uni Genius Academic Tutoring Scheme 2014-15
Experience
Previous experience working with young people is an advantage, but NOT a requirement.
Please provide details of any experience working with young people in any capacity that you have.
What skills do you have that would make you a good Academic Tutor?
Additional information
Have you ever been convicted of a criminal offence?
Yes ☐
No ☐
(If ‘Yes’, please indicate this when you return your application and request a criminal convictions
form to complete)
Would you be willing to be contacted about other programmes run by Generating Genius that would
require volunteers?
Yes ☐
No ☐
How did you hear about this opportunity?
Generating Genius Website
☐
University outreach department (please state university)
Voluntary Services Unit (UCL)
☐
Social Media (please state which)
Other (please state)
Uni Genius Academic Tutoring Scheme 2014-15
Data Protection
Your information will only be used for the purposes of Uni Genius, including but not limited to all
processes associated with the administration of the Academic Tutoring programme, and will not be
shared with any external parties.
Declaration
I confirm that:
To the best of my knowledge the information that I have supplied above is correct at the time of
writing ☐
When claiming expenses the amount I claim for will truly reflect the value of the expenses that I
have amassed ☐
I give permission for my picture to be taken for the publicity purposes of Uni Genius ☐
I will inform Generating Genius if my contact details change ☐
Signed:
Print:
Date:
If you have completed this application form electronically, please attach and email to
support@generatinggenius.org.uk .
If you have completed a physical copy of this application form and are returning by post, please
address to:
Gideon Woldeslassie
Engineering Front Building, Room 2.09
University College London
Torrington Place
WC1E 7JE