Geographical Fieldwork Grants 2006 by Gnd6a7M1


									Page 1 of 2                                            (For office use only) REF     /2012

Learning & Leading Summer School
Student Nomination Form
For teachers nominating a student for the Learning & Leading
Fieldwork Summer School from 20-24 August 2012

Please ensure that you read the guidelines before completing this form.

1. Student details
Full name of nominated student

2. Your details (the teacher nominating the student)
Title                 First name                           Last name
Name of your
Your position
School address
Telephone numbers:
Daytime                       Evening                      Mobile

3. The school or college
Is the student studying in a     Yes       No
maintained school, sixth form
college or FE college?           Type of school/college:

4. Making a difference
Please describe how the summer school would make a difference to the student.
Refer to their personal development, geographical understanding, skills and
knowledge, further study at university and future career prospects etc. (Maximum
200 words)

5. Why the student couldn’t otherwise have such an experience
How does the Learning & Leading Summer School offer an opportunity that is
outside the student’s previous experience and which would not otherwise be
available to them. To the extent possible provide explicit evidence of challenging
circumstances experienced by the student. (Maximum 200 words)

Page 2 of 2                                            (For office use only) REF     /2012

6. Student responsibility
Please give an assessment of the student’s ability to participate in the programme
responsibly. (Maximum 200 words)

7. Additional Information
Please provide any additional information that you feel might help the selection panel
(Maximum 200 words)

8. How did you hear about the Learning & Leading Programme?

The information submitted in this application is to the best of my knowledge correct
at the time this application was made. Should any significant developments arise
after this application is made, I will keep the Society informed of such developments.

Name                                         Date

Please email the completed form directly to the Learning & Leading Project Co-
ordinator at the Society by Friday 4 May 2012:

The student’s application will be jeopardised if the teacher nomination form
does not arrive on time.

   Primary communication including acknowledgement of receipt will be by email.


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