FOR NLT STAFF USE
Select which hub/team this form is for
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Birmingham Hub
Black Country Hub
Blackpool Hub
Bradford Hub
Communities Team
Connecting Stories Team
Criminal Justice Team
Doncaster Hub
Early Years Team
Fundraising Team
Hastings Hub
Home Learning Environment Team
Love Our Libraries Team
Manchester Hub
Middlesbrough Hub
None
North Yorkshire Coast Hub
Nottingham Hub
Peterborough Hub
Read NE Team
School Services
Sport and Literacy Team
Stoke Hub
Suffolk Hub - Haverhill
Suffolk Hub - Lowestoft
Suffolk Hub - Stowmarket
Swindon Hub
Words for Work Team
Young Readers Team
Young Writers Team
Which KPI metrics does this form relate to? Please tick as many as suitable
Reach
Interaction
Engaged
Competition Entry
Is this just an expression of interest form or do you want to collect number of attendees?
Expression of interest
Number of attendees
Select which reporting quarter this work is being delivered in
Please select...
Q1 23/24
Q2 23/24
Q3 23/24
Q4 23/24
Q1 24/25
Q2 24/25
Q3 24/25
Q4 24/25
Please select whether this activity relates to Connecting Stories
Connecting Stories
First Name
Last Name
Are you completing this on behalf of a school or organisation?
School
Organisation
Which of the below categories best describes your school?
Mainstream School
Early Years Setting
Higher Education
Alternative Provision
Which of the below categories best describes your organisation?
Library
Food Bank
Community Organisation
Sports Team
Corporate Organisation
Not For Profit Organisation
Job Title (including subject if teacher)
Email Address
Address
Is this address a household or organisation?
Household
Organisation
School lookup
P
lease look up your school here, using the
name
or
postcode
.
If your school is not listed,
please leave this field empty
, and manually enter in the
School or Organisation Name
box below).
School or Organisation Name
Street Address Line 1
Street Address Line 2
City
Postcode
County
Country
Please select...
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos ( Keeling ) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Côte d ' Ivoire
Croatia ( Hrvatska )
Cuba
Cyprus
Czech Republic
Congo ( DRC )
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands ( Islas Malvinas )
Faroe Islands
Fiji Islands
Finland
France
French Guiana
French Polynesia
French Southern and Antarctic Lands
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia, Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Korea
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russia
Rwanda
Samoa
San Marino
São Tomé and Prìncipe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
St. Helena
St. Kitts and Nevis
St. Lucia
St. Pierre and Miquelon
St. Vincent and the Grenadines
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
United States Minor Outlying Islands
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Viet Nam
Virgin Islands ( British )
Virgin Islands
Wallis and Futuna
Yemen
Zambia
Zimbabwe
Does your school belong to one of these regions?
Haverhill
Lowestoft
Stowmarket
None of the above
How many will attend the event?
Which phase of school will the pupils belong to?
Please select...
Early Years
Primary
Secondary
Post-16
Which year group are the pupils from?
Please select...
Pre-Reception
Reception
Year 1 (5 - 6 years old)
Year 2 (6 - 7 years old)
Year 3 (7 - 8 years old)
Year 4 (8 - 9 years old)
Year 5 (9 - 10 years old)
Year 6 (10 - 11 years old)
Year 7 (11 - 12 years old)
Year 8 (12 - 13 years old)
Year 9 (13 - 14 years old)
Year 10 (14 - 15 years old)
Year 11 (15 - 16 years old)
Year 12 (16 - 17 years old)
Year 13 (17 - 18 years old)