Please complete all questions

Please note: Priority will be given to undergraduates in their penultimate year (2nd year) but all undergraduates are welcome to apply. 

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* 1. First Name

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* 2. Surname

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* 3. Gender

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* 4. Date of birth

Date / Time

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* 5. Email Address (Personal not university)

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* 6. Telephone Number

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* 7. Home Address

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* 8. Please select your choice of lead school for the internship

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* 9. Please select your choice of subject for the internship

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* 10. Please provide the name of your university

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* 11. Please provide the name of your degree

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* 12. Current year of Undergraduate Degree

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* 13. Date due to complete Undergraduate Degree

Date / Time

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* 14. Predicted class of Undergraduate Degree

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* 15. What is the last date for the summer term at your university?

Date / Time

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* 16. Please provide your A-Level subjects and grades

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* 17. How will you most likely be commuting

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* 18. If a school has contacted you directly regarding the programme, please provide details below

T