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

* 1. Name:

* 2. Contact Email Address:

* 3. Contact Phone Number:

* 4. Subject of study:

* 5. Year of study:

* 6. School name:

* 7. Possible teacher contact:

* 8. School Address:

* 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?

* 10. If yes, please give details.

* 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.

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

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