Sixth Form Application

Data Protection * Data Protection * Yes No

*_*_*_STUDENTS_HEADER_*_*_*

Student Forename *

Student Middle Name

Student Legal Surname *

Student Preferred Surname *

Student Home Address *

Student Post Code *

Student Mobile Number *

Student Gender * Student Gender * Male Female

Student Date Of Birth (DD/MM/YYYY) *

Student Email *

*_*_*_PARENT_1_HEADER_*_*_*

Title: 'Mr', 'Mrs', 'Ms', 'Other' *

Forename *

Surname *

Home Address *

Post Code *

Home Telephone Number *

Mobile Number *

Work Telephone Number

Email *

Relationship To Student *

Parental Responsibility * Parental Responsibility * Yes No

*_*_*_PARENT_2_HEADER_*_*_*

Title: 'Mr', 'Mrs', 'Ms', 'Other' *

Forename *

Surname *

Home Address *

Post Code *

Home Telephone Number *

Mobile Number *

Work Telephone Number

Email *

Relationship To Student *

Parental Responsibility * Parental Responsibility * Yes No

*_*_*_EMERGENCY_1_CONTACT_*_*_*

*_*_*_EMERGENCY_1_CONTACT_DETAILS_*_*_*

State ('Nan', 'Uncle', 'Friend' etc)

Forename

Surname

Work Telephone Number

Home Telephone Number

Mobile Number

*_*_*_EMERGENCY_2_CONTACT_DETAILS_*_*_*

State ('Nan', 'Uncle', 'Friend' etc)

Forename

Surname

Work Telephone Number

Home Telephone Number

Mobile Number

*_*_*_MEDICAL_INFORMATION_*_*_*

Do You Use An Epipen? * Do You Use An Epipen? * Yes No

Do You Have a Medical Condition or Disability? * Do You Have a Medical Condition or Disability? * Yes (Please state below) No (Go to 'Language, Nationality, Religion')

If you have a medical condition or disability we should be aware of, or if you have to take medicine / tablets on a regular basis, have epilepsy, diabetes, asthma, hay fever / allergies or any other medical condition or disability, please state.

*_*_*_LANGUAGE_NATIONALITY_AND_RELIGION_*_*_*

Ethnic Origin: Please State * Ethnic Origin: Please State * Asian Background Bangladeshi Black Background Black British Black Caribbean Black Ghanaian Black Nigerian Black Somali Chinese Gypsy / Roma Indian Latin / South / Central American Other Black African Other Ethnic Group Other Mixed Background Pakistani Traveller of Irish Heritage White and Asian White And Black African White And Black Caribbean White and Chinese White British White European White Irish White other Yemeni I refuse to say Other (please state)

If 'Other', Please State

Is English Spoken At Home? * Is English Spoken At Home? * Yes No

The Main Language Spoken At Home * The Main Language Spoken At Home * Arabic Bengali Chinese Cornish Cymraeg English Greek Hindi Italian Manx Portuguese Punjabi Spanish Turkish Urdu Other (please state)

If 'Other', Please State

Country Where You Were Born * Country Where You Were Born * United Kingdom Other (please state)

If 'Other', Please State

Your Religion: Please State * Your Religion: Please State * Roman Catholic Church Of England No Religion Other (please state)

If 'Other', Please State

IN COLLEGE

Meal Arrangements * Meal Arrangements * Free School Meal Paid School Meal Packed Lunch

Biometrics With Finger Recognition? * Biometrics With Finger Recognition? * Yes No

How Will You Travel To College? * How Will You Travel To College? * Bike Bus Car Taxi Train Walk

Photo Permission For College Publicity? * Photo Permission For College Publicity? * Yes No

Do You Have Special Educational Needs?

Have You Read The College Rules? * Have You Read The College Rules? * Yes No

Have You Read The Uniform Regulations? * Have You Read The Uniform Regulations? * Yes No

Does Your Child Require Exam Assistance? Does Your Child Require Exam Assistance? None Extra time Use of laptop Scriber Reader

Does Your Child Require Any Other Exam Assistance?

OTHER INFORMATION

Are Parents In The Armed Services? * Are Parents In The Armed Services? * Yes No

Are Parents Former Member Of Armed Services? * Are Parents Former Member Of Armed Services? * Yes No

Are You A Registered Carer? * Are You A Registered Carer? * Yes No

Do You Want Registered Carer Information? * Do You Want Registered Carer Information? * Yes No

Current School Or Last School You Attended *

Post Code Of Your Current Last School *

Are You In Public Care? * Are You In Public Care? * Yes No

*_*_*_A_LEVEL_CHOOSE_OF_4_MAXIMUM_OF_4_SUBJECTS_*_*_*

A Level Subject Options * A Level Subject Options * Art Biology Business Chemistry Dance English Literature Fashion Geography History Maths MFL (French/Spanish) PE Philosophy & Ethics Physics

*_*_*_VOLCATIONAL_CHOOSE_OF_4_MAXIMUM_OF_4_SUBJECTS_*_*_*

Vocational Subject Options * Vocational Subject Options * Business Health ICT Media Performing Arts Psychology Science (Grade 5 in science) Sport Travel