Virtual Routes Into STEM

First Name

*

Last Name

*

Gender

Address Line 1

*

Address Line 2

*

Town

*

County

*

Postcode

*

Country

*

Date of Birth

*

Student Email Address

**

Please use an email address you have to access to at all times, we will be sending your login details and further information to this address (keep checking junk/spam folder as some emails can end up here)

Nationality

Nationality 2 (required if you hold Dual Citizenship)

If your school is not listed, please click here to request it to be added, then type the name of the school into the field and carry on with your application.

School

If your school is not on the list, please select 'None'

Ethnic Origin

Did either of your parents attend university in this country or abroad?

NoYes

Do you qualify for pupil premium funding/free school meals?

NoYes

Do you have a recognised or diagnosed disability? (inclusive of learning disability)

NoYes

This will not affect your application in any way

Are you or have you ever been in local authority care?

NoYes

Do you have sole or shared responsibility for the care of a relative because they are ill or disabled?

NoYes

We have limited funds to support students financially but if you feel you need support in paying for the course please select yes

NoYes

Student Details

Additional Information

Have You Previously Achieved Any Industrial Cadets Awards?

Parent/Guardian Details