Your details
Surname / family name * (max. 40 characters)
First / given name * (max. 40 characters)
Middle name(s) (max. 40 characters)
Title
-- Please select --
Miss
Mr.
Mrs.
Ms.
Baroness
Brigadier
Brother
Canon
Captain
Colonel
Commander
Commodore
Councillor
Count
Dame
Dr.
Engr
Father
Frau
General
Group Captain
H Royal Highness
Herr
Honourable
Lady
Leader
Lieutenant
Lord
Madame
Major General
Marshall
Master
Pastor
Prince
Professor
Professor Sir
Rabbi
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Reverend
Reverend Doctor
Right Honourable
Right Reverend
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Sergeant
Sir
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SUN
Venerable
Gender
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Date of birth *
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Month
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Year
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Address line 1 * (max. 35 characters)
Address line 2 (max. 35 characters)
Address line 3 (max. 35 characters)
Town / city * (max. 35 characters)
Post / Zip code * (max. 12 characters):
UK Postcode
or international Post / Zipcode
Postcode / Zipcode not applicable
Country *
-- Please select --
United Kingdom
Afghanistan
Aland Islands
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 Darussalam
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
Congo, The Democratic Republic of the
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
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Guatemala
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Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic of
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia, The Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federated States of
Moldova, Republic of
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territory,Occupied
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, United Republic of
Thailand
Timor-Leste
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
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Home telephone (max. 20 characters)
Email address * (max. 50 characters)
Please confirm your email address * (max. 50 characters)
Home country *
-- Please select --
United Kingdom
Afghanistan
Aland Islands
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 Darussalam
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
Congo, The Democratic Republic of the
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands (Malvinas)
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See (Vatican City State)
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran, Islamic Republic of
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libyan Arab Jamahiriya
Liechtenstein
Lithuania
Luxembourg
Macao
Macedonia, The Former Yugoslav Republic of
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia, Federated States of
Moldova, Republic of
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestinian Territory,Occupied
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Reunion
Romania
Russian Federation
Rwanda
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syrian Arab Republic
Taiwan
Tajikistan
Tanzania, United Republic of
Thailand
Timor-Leste
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
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Details of your visit
What is your main subject area of interest? *
-- Please select --
Accounting and Finance
Aerospace and Mechanical Engineering
American Studies
Applied Community and Youth Work Studies
Archaeology
Architecture
Art History and Visual Studies
Audiology
Business Studies
Chemical Engineering and Analytical Science
Chemistry
Civil Engineering
Classics and Ancient History
Computer Science
Criminology
Dental Surgery and Oral Health Science
Drama
Earth Sciences
Economic and Social Studies
Economic Science
Electrical and Electronic Engineering
English Literature
Environmental Sciences and Environmental Studies
Geography
History
Information Systems and Business and Management
International Business, Finance and Economics
Language, Literacy and Communication
Law
Learning Disability Studies
Life Sciences (including Biology and Medical related disciplines)
Linguistics and English Language
Management and International Management
Management and Leisure
Materials Science and Engineering
Mathematics
Medicine
Middle Eastern Studies
Midwifery
Modern Languages
Music
Nursing Degree
Optometry
Pharmacy
Philosophy
Physics and Astronomy
Planning and Landscape
Politics and International Relations
Politics, Philosophy and Economics
Psychology
Religions and Theology
Science and Engineering Foundation Year
Social Anthropology
Sociology
Speech and Language Therapy
Textiles
What is your secondary subject area of interest?
-- Please select --
Accounting and Finance
Aerospace and Mechanical Engineering
American Studies
Applied Community and Youth Work Studies
Archaeology
Architecture
Art History and Visual Studies
Audiology
Business Studies
Chemical Engineering and Analytical Science
Chemistry
Civil Engineering
Classics and Ancient History
Computer Science
Criminology
Dental Surgery and Oral Health Science
Drama
Earth Sciences
Economic and Social Studies
Economic Science
Electrical and Electronic Engineering
English Literature
Environmental Sciences and Environmental Studies
Geography
History
Information Systems and Business and Management
International Business, Finance and Economics
Language, Literacy and Communication
Law
Learning Disability Studies
Life Sciences (including Biology and Medical related disciplines)
Linguistics and English Language
Management and International Management
Management and Leisure
Materials Science and Engineering
Mathematics
Medicine
Middle Eastern Studies
Midwifery
Modern Languages
Music
Nursing Degree
Optometry
Pharmacy
Philosophy
Physics and Astronomy
Planning and Landscape
Politics and International Relations
Politics, Philosophy and Economics
Psychology
Religions and Theology
Science and Engineering Foundation Year
Social Anthropology
Sociology
Speech and Language Therapy
Textiles
Which open day do you wish to register for? *
-- Please select --
22 June 2012 (Friday)
23 June 2012 (Saturday)
22 June - 23 June 2012 (2 days, Friday and Saturday)
Including yourself, how many people will be in your party? *
-- Please select --
1
2
3
4
Subject-specific sessions
Subject-specific sessions
Subject-specific talks are available for the open days on the following dates:
Friday 22 June 2012
Saturday 23 June 2012
You will be able to make bookings for subject-specific talks after completing this form.
If you have a disability and/or long-term health condition which may affect your experience at the open day, providing us with details will help us to ensure that your visit to the University is as enjoyable and beneficial as possible.
Do you have a disability and/or long-term health condition which may affect your experience at the open day? *
Yes
No
Prefer not to say
If "Yes" you may use this space to provide details of your health condition and/or disability (max. 255 characters):
How do you plan to travel to the open day?
-- Please select --
Car
Train
Coach
Other
Where did you hear about The University of Manchester?
-- Please select --
University website
Word of mouth
UCAS website/publication
School
Higher education/recruitment fair
Hotcourse website/publication
Independent publication
Postal mailshot
Pre-paid reply card
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Overseas agent
Other - for exceptional use only
In the future, The University of Manchester may wish to send you further information about our degree programmes. Please uncheck the box if you do not wish to receive this information.
If you have completed the form, please review your details to check they are correct, then press 'Submit' once only and wait for the acknowledgement page to be displayed. You will also receive this information via email to the address used to register above.
We look forward to welcoming you to our open day in June.