Pupil Application for the online MSC summer school (7-9 July 20) Journey to Medicine
Event Timing: 12:00 7th July  to 12:00 9th July 2020
The Event will be a live, collaborative project
Contact  erin@catalysis.org.uk

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Email *
HEE NHS
in Partnership with the University of Exeter medical school
We will select students for the summer school based on a range of eligibility criteria.  Please answer the following questions as fully as possible.
Which school do you attend?
• Are you eligible for free school meals?   *
Required
• Have you spent time in local authority care?   *
Required
• Are you a young carer? *
Required
• Have either of your parents got a university degree from either the UK or abroad?   *
Required
• Are you a refugee or asylum seeker? *
Required
• Are you estranged (living without family support)?   *
Required
What do you want to achieve from attending the MSC Summer School?  [150 word limit] *
Declaration.  The information provided is true and correct.  I understand that in providing incorrect information any offer of a place of a summer school can be revoked.  I am happy for this data to be shared with the teacher who will provide further information.
All students under the age of 18 require consent from a parent or guardian to participate in the Journey to Medicine Summer School.
Student’s Details
Name *
Date of birth *
What is your home address?
What is your home postcode?
Gender *
Personal Information of Parent/Legal Guardian. We need to know your details if we need to contact you
Name *
 Relationship to student *
Email address *
Telephone Number *
The student and a parent or legal guardian should read the information below. Please tick the appropriate boxes to indicate agreement.
I CONFIRM THAT I HAVE READ AND UNDERSTAND THE PROGRAMME INFORMATION FOR THE MSC SUMMER SCHOOL I GIVE CONSENT FOR MY CHILD TO TAKE PART IN THE PROGRAMME *
Required
Media
The organisers would like to take photographs / film footage of the summer school which may include the student. We wish to inform you of how and where these may be used before taking and using photographs / film footage of the event. Any photographs / film footage taken at our events will be stored in our secure digital server and may be shared with the University of Exeter Medical School and Medical School Council.  We intend to use the images and written profile, where appropriate, in our promotional material to tell others about the benefits of the residential. We would like to use your photograph, film footage, profile and quotes in publicity which may appear locally, nationally and worldwide. You have the right to request that your photo be removed from the digital server, and any unprinted / unpublished publicity material on the web. Please indicate which of the following places you consent to your image/profile being used. This is not a complete list of publicity channels, but is indicative of the types of location that Catalysis uses for promotional purposes: Please tick the box that applies in the following:  
*
I give permission for the following uses of any media outlined above to be used. We will keep your image/profile on our records for no more than five years. The information will only be used in accordance with GDPR legislation.
Required
A copy of your responses will be emailed to the address you provided.
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