School Module Sign up Form

Thank you for your interest in our programme. Note that filling in the form below does not guarantee you a space on the programme as we will prioritise schools with the most Widening Participation indicators. To see a list of our indicators please check our website: https://warwick.ac.uk/study/outreach/whatweoffer/primary/ Schools will be contacted at the end of November to confirm their place.

SCHOOL DETAILS

School Name:

Main Contact Title

Main Contact First Name

Main Contact Surname

Main Contact Role

Main Contact Email

Main Contact Phone

Number of Year 5 classes in your school

We strive to offer the same opportunities to all children but may not be able to do all Year 5 classes in your school due to our team capacity. When we contact you about the outcomes of your application we will let you know how many classes we are able to do. If you would like us to consider teaching the module to more than one class please indicate so below.

CLASS DETAILS

How many classes would you like us to come and teach

yes

If you answered yes to the question above please indicate the year groups of all the children in the class

Class size

MODULES This year, we have four modules on offer. We will always try and accommodate your preferred module subject but cannot guarantee that you will be given the subject of your choice.

Choice 1 Module

Choice 2 Module

If you have selected Insight Into Engineering please select which dates option you would be available for

Yes

Please indicate the exact times you would like the ambassadors to start and stop teaching your class

Yes

Privacy notice

This form will be used to manage your participation to our programme. Your participation and attendance at the events will be recorded and associated with your name and school, but no other personally identifiable data will be stored, and the data will not be used for any purpose other than as a record of your participation.

The University of Warwick is the Data Controller of any information you have entered on this form and is committed to protecting the rights of individuals in line with Data Protection Legislation. The University's Data Protection webpages provide further information on your rights and how the University processes personal data. If you wish to submit a data subjects rights request, make a complaint or report a suspected personal data breach, please contact the University’s Data Protection Officer by email at infocompliance@warwick.ac.uk.

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