SECTION 1 – PERSONAL INFORMATION
First name: / Last name:
Date of birth: / Gender:
Address: / Post code:
Contact number:
E-mail address:

PLEASE READ THE TERMS AND CONDITIONS LAID OUT IN SECTION 8 BEFORE FILLING IN THIS APPLICATION FORM, TO INSURE YOU ARE ELIGIBLE TO ATTEND

SECTION 2 – EMERGENCY CONTACT DETAILS – AT LEAST ONE MUST BE FILLED
CONTACT 1
Full name:
Relationship to you:
Contact number (home): / Contact number (mobile):
CONTACT 2
Full name:
Relationship to you:
Contact number (home): / Contact number (mobile):
SECTION 3 – MEDICAL INFORMATION
Do you have any medical conditions? (including any allergies)
Will you be taking any medication during the event? / Yes / No
Do you have special needs or a registered disability? / Yes / No
If ‘Yes’ please provide details:
SECTION 4A – ACADEMIC
School/college name:
School/college address:
Please list the qualifications you are currently studying, and their predicted grades:
Subject / Qualification type / Current Grade / Predicted Grade
Please note you must be studying a level 3 science qualification to participate, including Biology or Chemistry
SECTION 4B – PROJECT CHOICE
There are 3 options of laboratory projects to take part in at the summer school. Below are details of these projects, and then you will be asked to rank them in order of preference. We try to accommodate first choices for all successful applicants but cannot guarantee this. It is also very difficult to switch projects after they have been allocated, so please decide carefully now. These projects are subject to change but all affected applicants will be notified if this is the case.
All of the projects are based on those used with undergraduates. Everyone will be using University-grade equipment and undergraduate-level laboratory practical skills.
BIOLOGY PROJECT:
This project looks at how gut absorption works by studying the glucose transport in intestinal rat tissue
BIOMEDICINE PROJECT:
Looking at the pharmacology of a drug commonly used in opthalmology (e.g treating glaucoma) and its effect on tissues.
BIOCHEMISTRY PROJECT:
Using spectrophotometry, you will analyse ‘patients’ to decipher their symptoms and test if they class as anaemic or not, by looking at the concentration of haemoglobin in their ‘samples’.
Please now rank the projects in order of preference:
1
2
3
SECTION 5 – PERSONAL STATEMENT
Please answer the questions below as fully as possible – your answers will be used to discern between similar candidates.
Why do you want to study Biological Sciences at University? (max 200 words)
What are you looking to get out of the University of Leeds Summer School? (max 100 words)
Why are you interested in visiting the University of Leeds Biological Sciences department? (max 100 words)
SECTION 6A – EQUAL OPPORTUNITIES
Has either of your parents/guardians studied at university? / Yes / No
Occupation of parent/guardian one:
Occupation of parent/guardian two:
What is your ethnicity?
SECTION 6B – SCHOLARSHIP APPLICATION
For students who fulfil certain criteria, the University will consider waiving the fee for the event and reimbursing travel to and from it. You can find out more about the criteria listed below at There are a limited number of scholarships available, so you may be offered a place but not a scholarship – your Summer School offer pack will tell you more in May 2017
Are you applying for the fee and travel scholarship for this Summer School? / Yes / No
If ‘yes’, please tick which criteria you meet from the University of Leeds’ Access to Leeds scheme:
  • Live in a geographical area with low levels of progression onto higher education
(see a list of eligible postcodes)
  • From a household with an annual income of £25,000 or below
OR in receipt of 16-19 Bursary Fund or Discretionary Learner Support with income threshold of £25,000
OR in receipt of free school meals during their GCSE studies
  • In the first generation of their immediate family to apply to higher education

  • Attends, or have attended, a school which achieved less than the national average at GCSE(5 A* to C passes including English & Maths)

  • Only option is to attend a local university

  • Studies disrupted by circumstances in their personal, social or domestic lives

  • Living or grew up in public care

SECTION 7 – BEHAVIOUR BOND
The Summer School has a code of behaviour that every attendee will need to sign before accepting a place. Please read the guidance below, before applying, to ensure you can agree to it should a place be offered.
Year 12 Summer School Code of Behaviour
The University of Leeds wants all students to benefit from the Y12 Biological Sciences Summer School and to enjoy this new experience. In order to ensure this, you will be expected to show responsible behaviour whilst attending as well as respect for the rights of other participants, students and staff. The rules described below are not designed to be restrictive and are ultimately for the participants’ benefit.
The following rules and regulations will be in operation throughout the Y12 Biological Sciences Summer School.
  • Alcohol must not be brought onto the site or consumed during the Y12 Biological Sciences Summer School
  • The purchase, sale or use of any illegal substance is strictly forbidden and will be referred to the police
  • Participants are expected to attend all timetabled activities (unless there is a valid reason for absence, such as illness)
  • Students are not allowed to leave the site without permission from staff
  • Students are expected to follow any health and safety procedures (e.g. in laboratories) as directed by staff
  • Students are expected to wear appropriate clothing and footwear in the laboratory practicals. Students who are not appropriately attired may not be permitted to participate in laboratory sessions.
  • Students are expected to follow any emergency procedure, such as a building evacuation, as directed by staff
  • Students are expected to treat all participants, staff and students involved with the Y12 Biological Sciences Summer School with respect and in line with the University’s policy on equal opportunities
In the event of a serious incident of misbehaviour, disruption or infringement of the above rules, the participant concerned will not be allowed to continue on the Y12 Biological Sciences Summer School and arrangements will be made to remove the participant concerned from the event. No refunds will be given in such circumstances. Emergency contact details may be used to inform parents/guardians of any such circumstances.
On the first day of the Y12 Biological Sciences Summer School, staff may explain some additional rules and regulations that will apply to specific activities undertaken on the day. As such, it is expected that you will adhere to them, in accordance with the expected behaviour outlined above.
I HAVE READ AND AGREED TO THE ABOVE CODE OF BEHAVIOUR:
SECTION 8 – TERMS AND CONDITIONS
Please read these terms and conditions before filling in this application form, to insure you are eligible to attend.
Year 12 Summer School Terms and Conditions
  1. The Y12 Biological Sciences Summer School is suitable for students in Year 12 (or equivalent) with an interest in the biological sciences. They should be studying science subjects, Biology, Chemistry, Physics, or Maths at AS level or other comparable qualification (see for details of entry requirements). Students need to be studying Biology or Chemistry to attend
  2. Applications will be received until April 20th 2018. After this date no further applications will be accepted.
  3. Only applications that are fully filled will be accepted. This includes indicating that the codes of behaviour and terms and conditions have been read and agreed to. If these are not ticked, we will ask you to again if you are offered a place. We will not be able to allow students to attend who have not agreed to these two sets of conditions.
  4. Parental consent will be required. This will be sent out upon acceptance of a place also need to be signed
  5. Delegates who do not have written parental consent and/or have not paid the appropriate delegate fee will be excluded.
  6. No refunds will be given for cancellations after June 2nd 2018
  7. Delegates claiming refund of travel expenses under the Access to Leeds eligibility criteria must submit proof of travel expenses at the end of the event.
  8. The safety and well being of delegates on the journey to and from the University is not the responsibility of the University. If the student fails to attend, or leaves early, the University shall not be held responsible and accepts no liability for their welfare.
  9. The University accepts no responsibility for loss or damage of property.
  10. Photographs taken by the University of Leeds during the event may be used in future publicity materials. It is the responsibility of the parent/carer to inform the University of Leeds of any student who does not have consent to be photographed.
  11. Some activities may involve 5 minutes of light to moderate exercising. These will not be excessive and the heart rate of each student will be monitored and will not go above 160 beats per minute. The only risk is if the student has exercise-onset asthma or has recently suffered from a respiratory infection and we would advise such students not to volunteer as subjects. The students will also be looking at traces of the heart by a well used technique known as ECG. This involves fitting electrode on to the skin by sticking plaster. If the student has an allergy to sticking plaster then they should not volunteer.

I HAVE READ AND AGREED TO THE ABOVE TERMS AND CONDITIONS: