Sixth Form Application Form

Before completing this Form, please ensure that you have completed the Predicted Grades form which can be downloaded here

PLEASE NOTE THAT THE DEADLINE FOR SUBMISSION OF THIS ON-LINE FORM IS WEDNESDAY 18 DECEMBER 2019

Sixth Form Admissions Form - External Students

Student's Name

First* Last* Student's Date of Birth*

Student's Home Address

Address Line 1* Address Line 2 Town / City* Postcode* Student's Email Address* Student's Mobile Number*

Parent / Carer's Details:

Parent / Carer's Name

First* Last* Home Telephone Number* Parent / Carer's Email Address* Parent / Carer's Mobile Number*

Current School's Details

Name of Present Schoo* Date Started*

School Address

Address Line 1* Address Line 2 Town / City* Postcode* School Telephone Number* School Email Address*

A LEVEL SUBJECT CHOICES

Please list in descending order of preference the 3 subjects you would like to study.

1st* 2nd* 3rd*

FURTHER MATHEMATICS

Students wishing to take Further Mathematics must do so as a fourth A level. Please note that the subject criteria is a Grade 9 in Mathematics GCSE.

4th*

Current Subjects

PLEASE LIST ALL OF THE SUBJECTS YOU ARE CURRENTLY STUDYING AT GCSE (FULL COURSE ONLY) AND INCLUDE YOUR LATEST PREDICTED GRADE. PLEASE LIST SUBJECTS IN ORDER OF THE HIGHEST GRADE.

Subject 1 Subject 1 Predicted Grade* Subject 2 Subject 2 Predicted Grade* Subject 3 Subject 3 Predicted Grade* Subject 4 Subject 4 Predicted Grade* Subject 5 Subject 5 Predicted Grade* Subject 6 Subject 6 Predicted Grade* Subject 7 Subject 7 Predicted Grade* Subject 8 Subject 8 Predicted Grade* Subject 9 Subject 9 Predicted Grade* Subject 10 Subject 10 Predicted Grade* Please upload a completed copy of the predicted grades form which has been signed and stamped by your current school. If you do not have a copy of the completed predicted grades form which can be downloaded above, please ensure a copy is emailed to admissions@wallingtongirls.org.uk as soon as possible. No file chosen

By ticking this box the applicant agrees that all the information supplied is correct*

PLEASE ASK FOR THE FOLLOWING 3 NUMBERS FROM YOUR PRESENT SCHOOL

UPN ULN UCI

SUPPORTING YOUR APPLICATION

Are you, or have you even been, looked after by a Local Authority. If YES, please tick this box. (Supporting evidence in the form or a care order, residence order or similar should be submitted).*

Do you have a special educational need?*YesNo

If yes, please give details here.

Do you wish to put forward any medical and/or social reasons in support of your application? (This may include refugees or asylum seekers). Written evidence will be required from a doctor, social worker or education welfare officer.*YesNo

If YES, please state here. If NO please leave blank.

If you have triggered Pupil Premium, please tick this box. (This will be verified if you are offered a place with us)*

Please state date from which Pupil Premium was first received

Wallington High School for Girls