Chemistry at Work Exhibition - Application Form Tuesday 22 and Wednesday 23 November 2016 School of Chemistry and Chemical Engineering (QUB) and The Royal Society of Chemistry APPLICATION DEADLINE: FRIDAY 11 NOVEMBER 2016 * Required details. TEACHER CONTACT DETAILS * Title *: Mr Mrs Ms Miss Dr Prof Rev Fr Sir Dame First name *: Surname *: Email address *: School *: Choose a School Other – Northern Ireland Other - England Other - Scotland Other - Wales Other – Isle of Man or Channel Islands Other -EU Other – non-EU international Abbey Christian Brothers Grammar School Antrim Grammar School Aquinas Diocesan Grammar School Ashfield Girls High School Assumption Grammar School Ballyclare High School Ballymena Academy Banbridge Academy Bangor Grammar school Belfast Boys Model School Belfast High School Belfast Metropolitan College Belfast Royal Academy Bloomfield Collegiate Cambridge House Grammar School Campbell College Carrickfergus Grammar School Christian Brothers School Christian Brothers Secondary School Colaiste Feirste Coleraine Academical Institution Coleraine High School Convent Girls School Cookstown High School Corpus Christie College Cross & Passion College Dalriada School Dominican College Down High School Enniskillen Collegiate Erne Integrated College Fivemiletown High School & Com. College Foyle & Londonderry College Friends School Glengormley High School Glenlola Collegiate Grosvenor Grammar School Hazelwood College Holy Cross College Hunterhouse College Kilkeel High School La Salle Boys School Lagan College Larne Grammar School Limavady Grammar School Lismore Comprehensive School Little Flower Girls School Loreto College Loreto Grammar School Lumen Christi College Lurgan College Methodist College Mount Lourdes Grammar School Newbridge Integrated College Newry High School Oakgrove Integrated College Omagh Academy Our Lady & St Patrick's College Our Lady's Grammar School Parkhall High College Portadown College Portora Royal School Rainey Endowed School Rathmore Grammar School Regent House School Royal School Armagh Sacred Heart College Sacred Heart Girls School Shimna Integrated School Slemish College St Catherine's College St Colman's College St Colman's High School St Columb's College St Dominic's High School St Eugene's College St Genevieve's High School St Joseph's College St Joseph's Convent Girls School St Louis Girls School St Louis Grammar School St Louise's Comprehensive College St MacNissi's College St Malachy's College St Malachy's High School St Mary's Christian Brothers Grammar School St Mary's Grammar School St Michael's College St Michael's Grammar School St Patrick's Academy St Patrick's Grammar School St Patrick's High School St Paul's High School St Rose's High School Strabane Academy Strabane Grammar School Strathearn School Sullivan Upper School The Royal Belfast Academical Institute The Royal School Armagh The Royal School Dungannon Thornhill College Victoria College Wallace High School Wellington College Enter the name of your school below if it does not appear in the list above. Other school: School address : School Tel No. : You are invited to send at least one group of up to 25 pupils to the exhibition, which will be strictly programmed. The number of groups to be accepted is limited and allocations will be made in order of receipt of applications. If numbers permit, it may be possible to accept more than one group from a school, with an application maximum of 2 groups of 30 pupils each. Please rank the sessions you prefer to attend (up to 4), and the number of groups and total number of pupils you will send. 1st Choice2nd Choice3rd Choice4th ChoiceNo. of GroupsNo. of Pupils Select session Tues. AM 22 November 2016 Tues. PM 22 November 2016 Wed. AM 23 November 2016 Wed. PM 23 November 2016 Select session Tues. AM 22 November 2016 Tues. PM 22 November 2016 Wed. AM 23 November 2016 Wed. PM 23 November 2016 Select session Tues. AM 22 November 2016 Tues. PM 22 November 2016 Wed. AM 23 November 2016 Wed. PM 23 November 2016 Select session Tues. AM 22 November 2016 Tues. PM 22 November 2016 Wed. AM 23 November 2016 Wed. PM 23 November 2016 NOTE: AM sessions 9:40-12:15 & PM sessions 12:55-15:30. Please do not request a morning session UNLESS YOU ARE ABLE TO ARRIVE BY 9:30 am. As far as possible, efforts will be made to accommodate your chosen session. Finally, please let us know about any requirements which would facilitate your visit. We do prefer that you attend for the entirety of your allocated session, however please let us know if and when you have to leave early due to travel constraints. [Enter comments] Early application is advised as places will be allocated on a first come basis. Please Submit Your Form For more information about this event contact Ken Pringle.