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Summary: MTH6110
UAS Placement Agreement
This is an agreement between the student, the module organizer and the host organization/mentor
teacher. It is a negotiated document that sets out the anticipated tasks that the student will initially
undertake and specifies the expected pattern of attendance. It is expected that the Undergraduate
Ambassador (UA) will spend 3-4 hours per week, for 10-weeks, working in the local school.
Details of Student, Host and Module Organizer
Name of Student ___________________________________________________
Address ___________________________________________________
___________________________________________________
Telephone Number ___________________________________________________
E-mail ___________________________________________________
Name of Mentor Teacher ___________________________________________________
Address ___________________________________________________
___________________________________________________
Telephone Number ___________________________________________________
E-mail ___________________________________________________
Name of Academic Adviser Dr. Craig Agnor___________________________________
Address School of Mathematical Sciences___________________
Queen Mary University of London, E1 4NS________
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