Apply to 2018 Humanities Residential Step 1 of 2 50% Personal DetailsInformation submitted here will be used sent to your nominating teacher as part of the application process. Information about how your personal information will be used by us in connection with the administration of this event/activity, and for related purposes, is available at http://www.undergraduate.study.cam.ac.uk/how-we-use-participant-data. Please contact email@example.com with any questions in the first instance.Your Name* First Name Surname Date of Birth* Email Address*Please make sure your email address is spelled correctly as if there are any mistakes we won't be able to contact you. How would you describe your gender?*How would you describe your ethnicity?*Address* Street Address Address Line 2 City ZIP / Postal Code Academic DetailsWhat school year are you currently in? Year 12 (Northern Ireland Year 13/Scotland S6) Year 11 (Northern Ireland Year 12/Scotland S5) Other Subject 1*A level or equivalentSubject 2Subject 3Subject 4Subject 5Subject 6GCSEs*Please summarise your GCSE results if you already have them, or your predictions if you are in Year 11Which subject(s) are you thinking of studying at university?Preference 1*Preference 2*Please outline why you would like to attend this residential:* Additional InformationLevel of Education of Parent/Guardian 1: Don’t know No formal qualifications GCSE/CSE/ O-level A-level /HNC/BTEC Vocational qualification HND/other Higher Education certificate Undergraduate Degree Masters Degree PHD Level of Education of Parent/Guardian 2: Don’t know No formal qualifications GCSE/CSE/ O-level A-level /HNC/BTEC Vocational qualification HND/other Higher Education certificate Undergraduate Degree Masters Degree PHD Have you ever been entitled to Free School Meals?YesNoPrefer not to sayDo you have a disability or medical condition which affects your studies?YesNoPrefer not to sayHave you ever been in care?YesNoPrefer not to sayAre you a carer for a parent/guardian or any other member of your family?If there are any particular circumstances that you wish to disclose that may have had a negative impact upon your education, please give details here:Your School InformationName of School*School TypeState ComprehensiveState GrammarState Sixth FormIndependentHome-schooledSchool Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Your Nominating Teacher* Mr.Mrs.MissMs.Dr.Prof.Rev. Prefix First Last Nominating Teacher's Email Address:*Please make sure this is spelled correctly - without an accurate email address we will be unable to contact your teacher. CAPTCHANameThis field is for validation purposes and should be left unchanged.