Admin

DATA COLLECTION FORM: Parent

Who are we?

East Midlands Widening Participation Research and Evaluation Partnership (EMWPREP) is a collaboration of Midlands-based Higher Education providers that offers a targeting, monitoring and evaluation service for the outreach initiatives delivered by each partner. Detailed information on EMWPREP and how we collect and use the data can be found at: www.emwprep.ac.uk/privacy-notice

Why are we collecting this information?

Your child / dependant is taking part in a Higher Education provider (university / college) outreach or recruitment activity. To ensure this and any further activities they take part in are useful, effective and reaching the right young people, we need to gather certain information (including information about your child / dependant's ethnicity and disability status) which will be analysed and used by EMWPREP and partners for research purposes only. This information also helps us demonstrate to funders, such as the Office for Students (OfS), the value and impact of the activities we deliver.

Will we share the data you provide?

For research purposes we may share the data held on this form with the following receiving organisations:

our partner universities and colleges,
your child / dependant's school or college,
your child / dependant's school or college's Local Authority,
third-party activity providers working with partner universities and colleges, and
third-party data processors working with partner universities and colleges.

What research do we do?

EMWPREP and the receiving organisations may then link data from this form to other educational data already held about your child / dependant (including Department for Education data held on the National Pupil Database, Individualised Learner Record data, UCAS records and/or HESA student records). We may access this data and use it to see if university or college activities have made a difference to your child / dependant's future progression.

From time to time we may publish reports on our research, all data will be nameless, and individuals cannot be identified. The data will not be used for any other purpose.

Do you want more information?

Data will be processed in accordance with the relevant data protection legislation. For more information, please see www.ico.org.uk/ or call 01509 223462.

Having read the above, we would be really grateful if you could take a few minutes to complete this form.

Completing the form

The form below is split into two sections, you can submit the form after completing student details or you can complete an expanded full form version.

* Required fields

Student details

First Name *

Last Name *

Birthdate DD/MM/YYYY *

Year group

Address1

Address2

Town

County

Postcode*

School/College Name *

Targeting and monitoring

What best describes the gender your child / dependant identifies with?

Have you or the child's other parents or carers studied at a university or taken a degree?

Have any of the child's siblings, aunties/uncles or cousins studied at a university or taken a degree?

Has your child / dependant been eligible for Free School Meals at any time in the last six years?

Has your child / dependant been in care?

Please select Yes if:

Your child/dependant has spent any time living in public care as a looked after child including: in local authority care and living with foster carers or in a children's home
Your child/dependant has been 'looked after' at home under a home supervision order in Scotland

Please select No if:

Your child/dependant has not spent time in care.

Please note this does not refer to time spent working in a care or healthcare setting or if your child/dependant is or has been a carer for a relative.

Do you consider your child / dependant to be a young adult carer?

Please select Yes if:

They are a young person who cares, unpaid, for a family member who due to illness, disability, a mental health problem or an addiction cannot cope without their support.

Have you or the child's other parents or carers served in the Armed Forces or reserves during their childhood?

What best describes your child / dependant's ethnicity?

What best describes child / dependant's status?*

Does your child / dependant have a disability?

Disabilities

Future contact

On occasion EMWPREP and/or receiving organisations may wish to contact your child / dependant and invite them to participate in additional research about activities they have taken part in.

I agree for my child / dependant to be contacted to be invited to take part in additional research

To sign up to receive further information from University of Derby [10007851] including emails containing information, advice and guidance about future education options please provide details below. (These details will NOT be passed to any third parties other than the CRM provider).

I would like my child / dependant to receive further information from University of Derby [10007851]

To be sent to the following email address:

I would like to receive further information for parents/carers from University of Derby [10007851]

To be sent to the following email address:

Name of parent/carer (by writing your name you are consenting to your child / dependant being contacted as described above): * (required if further information to be received)

Date: