UCL Horizons Summer Challenge 2013 Teacher Reference Form

Before completing this form, please ensure that you and the student have read the Summer Challenge brochure to ensure that you understand our application process and selection criteria.

If you are providing references for more than one student, please note that you will need to complete the reference form separately for each student.

We will not consider applications from students which do not have an accompanying teacher reference.

We will advise all students and teachers of the selection decisions by Friday 26 April.

Please note that the Middle East course described in early versions of the brochure has now been cancelled. We are now offering a new course in English Literature, Shakespeare Updated.

Section One: Teacher Details

Title

First name:

Last name:

Job title:

Name of school:

Local authority of school:

Relationship to student (e.g. form tutor):

Your work phone number (and extension):

Your work email address:

Section Two: Academic reference

Full name of Year 12 student:

Is this student registered as Gifted and Talented?

Please list all the qualifications this student is currently taking, with their current predicted grades (for example "A Level French - currently predicted B"; "IB Higher Biology - currently predicted 6")

Add another qualification

If you have additional comments you want to make about this student’s academic ability or their personal circumstances that would support their application, please add them here. They will help us in our decisions.

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