Application Form - For entry into Secondary Mathematics Teacher Training from Autumn 2014

Please complete the following questions and return the form to Scholarships@ima.org.uk or by post to: The Institute of Mathematics and its Applications Catherine Richards House 16 Nelson Street Southend-on-Sea Essex SS1 1EF

Personal Details
Title First name Last name Date of Birth Miss Sara Sheikh 01/05/1992

Contact Details
Email address Telephone Mobile telephone sarafsheikh92@gmail.com 02082302059 07739575227

Permanent Address

Address

6 Roseville Avenue

Town Postal Code Country

Hounslow TW3 3TD England

Please note that if you are shortlisted, wherever possible you will be invited to attend an appropriate regional assessment centre.

Contact Address, if different, eg. University term address

Address

Town Postal Code Country

Eligibility
Are you an EU National? (Please tick appropriate box) Yes / No

Have you been a resident in the EU in the past three years? (Please tick appropriate box) Yes / No

If you have answered no to either or both of these questions, please demonstrate how you meet the required criteria that you qualify as a home student, be eligible to draw a tuition fee loan from the Student Loans Company and meet the bursary eligibility criteria set out in the NCTL bursary guidance. If you cannot easily demonstrate this please contact the Student Loans Company BEFORE continuing your application.

Qualifications
Please name the University where you completed or are studying for your undergraduate degree (if applicable). If this is outside the UK please state the country. City University London

Please state the type, subject and classification (including any honours) of your undergraduate degree eg BSc (Hons) Mathematics 2.1. If you are in your final year you should include your expected degree class. If your degree was awarded outside the UK please demonstrate how this is equivalent to a UK degree using the overseas grade comparison table (www.gov.uk/government/uploads/system/uploads/attachment_data/file/181151/overseas_grade_comparis on-table.pdf). You may wish to send a NARIC statement of compatibility and any transcripts with your application as this will enable it to be processed more quickly. BSc (Hons) Mathematics 2.1

Year of Graduation Predicted/achieved

2014 2:1

Other qualifications e.g. Higher Degrees(s), if applicable

Please list any applicable postgraduate degrees or qualifications. Please note that if your degree was awarded outside the UK you may be contacted for further information. Qualification Type (Masters, PhD, other- please specify) Course Name Provider Qualification Type (Masters, PhD, other- please specify) Course Name Provider Completion Date Completion Date

A-level subjects and grades, foundation degree, HND, HNC or equivalent qualifications and grades
Qualification A-level A-level A-level AS-Level AS-Level Subject Mathematics Graphic Design Sociology Further Mathematics Economics Grade A A B C D

Other equivalent qualifications, grades/marks

Mathematics Subject Knowledge Enhancement (SKE) course, if applicable

Course Name Provider Length of Course Completion Date

Initial Teacher Training Application

Please note that you do not have to have applied for, or been offered an initial teacher training place to apply for a Scholarship, however it is dependent upon you commencing an eligible course in England during the 2014/15 Academic year. Have you applied for or been offered an initial teacher training place in 2014/15?

Applying for PGCE for year 2014/15

Type of training (PGCE/SCITT/unsalaried School Direct) Provider Subject/Course Title Where you are in the application process PGCE Secondary Sending application PGCE

About Yourself
In this section we would like you to tell us a bit more about yourself and why you are applying. Current/Last Employment Job Title Organisation Full/Part time Dates of Employment Customer Consultant Carphone Warehouse Part time 01/10/11

Provide a brief summary of your employment history, including any voluntary work, and explain how you meet the criteria required for a Maths Scholar. You should include any relevant experience, interests and hobbies to support why you feel you could inspire others with your passion for maths and your understanding of the importance of teaching and learning of maths to individuals and the UK as a whole.

Do you have a disability that means you will require support for an interview or written exercise (e.g. extra time, access arrangements), if so please give details.

Are there any dates or time periods that you would NOT be available to attend an assessment centre or interview (e.g. booked holidays, examination periods, work experience placements or graduation ceremony).

How did you find out about the Mathematics Scholarship Scheme?

Referee Details
Please provide details of a referee. If you have graduated in the past 3 years or are on an SKE course this should be an academic referee e.g. a course tutor. If you graduated more than 3 years ago we prefer a suitable professional individual with a professional email address (for example one where the domain name is an institution or company). We may contact your referee in the near future, so please obtain their permission as soon as possible, if you have not done so already. Title and Name University/college or company name Email address Phone number Relationship to you (e.g. course tutor) I confirm that all the information provided in this form is accurate to the best of my knowledge and give permission for my contact details to be shared with the DfE and if offered a Scholarship with other bodies involved in the scheme. Signature Date

If youve not done so already, we strongly recommend that you register on the Department for Educations Get into Teaching web pages at www.education.gov.uk/teachregister. You will receive all the latest news and information about getting into teaching as well as access to exclusive one-to-one advice and events as part of their Premier Plus service. Premier Plus is open to everyone with (or predicted) a first, 2:1 or 2:2 degree who is interested in teaching maths in the 2013-14 academic year. Your scholarship application status does not affect your eligibility for Premier Plus.

Mathematics Test
Please complete all of the questions in the mathematics test. Please note that your application will not be considered if a completed test is not submitted with this form.

Equal Opportunities Monitoring

The following information is required for monitoring purposes only and will not form part of the application process. Please tick the relevant boxes. Male White British White Irish White - Other Female Mixed White and Black Caribbean Mixed White and Black African Mixed White and Asian Mixed - Other Black/Black British - Caribbean Black/Black British African Black/Black British Other Asian/Asian British - Indian Asian/Asian British - Pakistani Asian/Asian British - Bangladeshi Other Asian Background Chinese Other