First name Please enter your name.

Last name Please enter your second name.

Email Address Please enter your email address.

Phone number Please enter your telephone number.

Address Line 1

Address Line 2

Address Line 3

Town

County

Postcode

Name of college /
place of work Please enter your college / place of work.

Name of first
choice university Please enter your first choice university.

Where did you
hear about this
competition? Please Select Google Further Education magazine The Student Room 69 magazine UCAS website My college A university Other (Please Specify)

If other, please specify:

Will you be able to travel to our offices in Nottingham in
March 2010 (date TBC) for an interview if you are a finalist? Yes No Please select if you can travel.

Will you be living away from your current address in the
first year of university? Yes No Please select if you will be liviging away.

Type your
100 word
entry here

N.B. Only the first 100 words will be submitted

Please Note: Proof of university application will be required at the interview stage.

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you agree to
the terms and conditions
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