This form must be completed by a parent/carer.  Please read the Admissions Policy before proceeding.

* 1. Student surname

* 2. First name(s)

* 3. Name known as (if different)

* 4. Legal name (if different)

* 5. Date of Birth

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* 6. Gender

* 7. Contact landline number

* 8. Student's normal home address (without postcode)

* 9. Postcode

* 10. If you know your address will be changing before 31 October 2016 please record the new address here and give the date you will be moving.

* 11. Surname of a parent or carer

* 12. Parent or carer's first name

* 13. Relation to the student

* 14. Has either parent been a serving member of the armed forces of the UK or its allies at any point since 2011? (Please note proof will be required if this triggers priority admission)

* 15. Parent or carer's home landline (only if different to the contact number given above)

* 16. Parent or carer's mobile number

* 17. Parent or carer's email address

* 18. Parent or carer's home address (only if this is different to the student's)

* 19. In what local authority area do you pay Council tax?

* 20. If you have it available please give your Council Tax reference number.  This will only be used if home location is applied as an over-subscription criterion.  If you don't know your Council Tax reference number this is not a problem but we may ask you to supply it at a later date.

* 21. Please list the subjects the student will be studying in this academic year.

* 22. What sort of job would the student like to be doing in 10 years' time?

* 23. How did you first hear of South Wiltshire UTC?

* 24. Has the student received free school meals at any point since 2012? (Please note we may ask for evidence at a later date if this is used as an over-subscription criterion).

* 25. Please select the school the student currently attends from this list or add its name if it is not shown.

* 26. Does the student have any brothers or sisters already attending South Wiltshire UTC?

* 27. Does the student have a parent currently working at the UTC?

* 28. Is the student currently looked after by a local authority, or foster parents acting on behalf of a local authority, or has the student ever been looked after in this way during their secondary school career?

* 29. Please give the name of the person submitting this form:

* 30. The person named in question 29 must click each of the statements below.

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