*Please do not contact your former school until you have attended an information session*

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* 1. Name:

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* 2. Contact Email Address:

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* 3. Contact Phone Number:

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* 4. Subject of study:

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* 5. Year of study:

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* 6. School name:

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* 7. Possible teacher contact:

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* 8. School Address:

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* 9. Have you been back to or delivered a talk or activity at your old school/ college since you started at the University of Reading?

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* 10. If yes, please give details.

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* 11. Have you ever assisted on events/ delivered talks to prospective students on behalf of the University of Reading? E.g. for open days, visit days, campus tours, school groups etc.

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* 12. If yes, please give brief details of the kinds of activities/talks you have been a part of:

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