Please ensure that all questions marked with a red asterisk are completed Which degree(s) in particular are you interested in? * DentistryMedicineLawOther If other then please specify: Where did you hear about Reach? * Please select... Guidance Teacher Poster in school Careers Advisor Friends Family Lift Off Reach/ACES visited my school Other Please tell us how you heard about us Personal Details Surname/Family Name * First Name(s) * Date of Birth * (dd/mm/yyyy) Age * Gender * MaleFemalePrefer not to say If other, please specify Postcode * Address * Town/City * Home Tel Number * Mobile * Email Address * We will send your confirmation information to this email address. Additional Personal Details This next section does not need to be completed to allow you to enrol onto the Reach project, however, the Reach team would like to be aware of these issues so as to be able to help applicants as much as possible. If you have a disability, please provide more information and indicate any additional support requirement. Please tick all relevant boxes: I am the first in my family to apply/go to universityI receive free school mealsI am a young carerI have spent time in careI am in receipt of an EMA grant About Your School What is the name of your School? * Please select... Arbroath Academy Arbroath High School Baldragon Academy Blairgowrie High School Braeview Academy Brechin High School Craigie High School Crieff High School Forfar Academy Harris Academy Montrose Academy Morgan Academy Perth Academy Perth Grammar School St John's RC Academy St John's RC High School St Paul's RC Academy Other Please supply the name of your school Scottish Candidate Number, please contact your school office if you do not know what this is - you do have one! Do not delay in completing this form - you can always email it to us later. Which year will you be in from August 2018? * S3S4S5S6 Qualification profile We would like to know about the subjects you are studying or have studied at school. Please include all subjects, levels and the grades achieved or predicted for each year. For example: National 4/5 (insert year obtained): English A; Mathematics A; etc Qualifications gained/predicted from S4 Subjects Taken in S5 Qualifications gained/predicted from S5 Subjects Taken in S6 Qualifications gained/predicted from S6 Consent I wish to participate in the Reach Project and agree that my personal data can be used for the purposes described in the Reach Privacy Notice: I have read the Reach Privacy Notice and I wish to participate. * YesNo ADDITONAL OPTIONS a. Permission to provide evidence of your participation in Reach to other universities If you apply to the University of Dundee or to another university, we can provide information to them about your involvement in Reach if requested. I agree that my data can be shared with other universities to support applications that I make * I agreeI do not agree b. Permission to follow your progress at university to improve Reach We would like to follow your progress after Reach so that we can evaluate the success of the Project and improve it for future groups of students. The University of Dundee is partnering with the universities of Edinburgh, Glasgow, Aberdeen and St Andrews in the Reach Project. We would like to share data with our partner universities so that we can see if you enrol and progress at any of those institutions. This information will not be used to make any decisions about you and will only be retained in an identifiable way for one year after you graduate from a degree programme. I agree that my information can be shared between the Reach Project partners: * I agreeI do not agree c. Permission to contact you in future We would like to keep in touch with you during and after your participation in the Reach Project to discuss your experience of the programme and to find out how your career developed. We will use this information to evaluate and improve the programme and to let you know of any opportunities that we think might be relevant to you. If you are happy for us to contact you, please indicate how we may do so below. We will only contact you for up to one year after you take part in Reach. I would like to be contacted by Reach during the Project in the following ways (please tick all that apply): * PostEmail (or other electronic communications)TelephoneSMS/Text I would like to be contacted by Reach after the Project in the following ways (please tick all that apply - ticking no options means you do not want to be contacted): PostEmail (or other electronic communications)TelephoneSMS/Text Captcha Please enter the characters you see in this picture: Characters This helps prevent automated form submissions. If you are not sure what the characters are, make your best guess. You will have another try in the next screen. Need assistance with this form?