Sixth Form Application (External Applicants)

Surname (required)

Forenames (required)

DoB (DD/MM/YYYY)

Email Address (required)

Recent Photograph of Yourself (required)

Home Address (required)

Current School (required)

A Level / BTEC subject choices



I would like to join the Extra Curricular Football Academy: YesNo

Please list your personal qualities, hobbies and interests (required)

Please tell us your career aspirations after you have completed your sixth form studies (required)

Please list the schools you have attended since the age of 11

School 1

School:
Date Started:
Date Finished:


School 2

School:
Date Started:
Date Finished:


School 3

School:
Date Started:
Date Finished:


Please list the qualifications you have already attained:

Qualification 1

Subject:
Level e.g. GCSE:
Year Taken:
Result:


Qualification 2

Subject:
Level e.g. GCSE:
Year Taken:
Result:


Qualification 3

Subject:
Level e.g. GCSE:
Year Taken:
Result:


Qualification 4

Subject:
Level e.g. GCSE:
Year Taken:
Result:


Qualifications to be completed this year (required)

Are you receiving any additional support e.g. extra help with your reading or writing or help in the classroom taking notes?

Do you consider yourself to have a disability?

If yes, please tick any disability which applies to you, provide brief details below:








Do you have any health problems which could affect your learning?

If yes please give brief details:

I declare that the information given on this form is correct and that I agree to abide by the Helena Romanes Sixth Form Centre rules and regulations.

The approval of a parent or guardian is required if the applicant is under 18 years of age on September 1st 2019.




Parent/Guardian Name


Address


Contact Number

Please give details of any other relative who should receive Progress Checks, Reports etc. Please state name and address and relation to student

Privacy Notice

By ticking this box, you confirm that you have read the Privacy Notice

If you have any queries please contact Mrs Wright (Head of Sixth Form) on 01371 878636 or via email – pbarry@hrs.education

The deadline for completed Sixth Form Applications is Friday 14th December 2018.