Sixth Form Application

Applicant Details

First Name Surname Date of Birth Address Postcode Telephone Number Email Address

To ensure support continues into Sixth Form (Please tick to confirm)Are you eligible for Pupil Premium?Are you or have you previously been, looked after or in care?Do you receive any additional support in school e.g. for SEN or medical conditions?Is your household income below £25,000 (which would put you on our 16-19 Bursary)?

Current School

School Name School Address Postcode School Telephone Number Staff Contact Name Staff Contact Email

Examinations to be Taken this Academic Year

Places in the Sixth Form are offered on the basis of the following criteria:
• A minimum of Grade 5 in either English Language or Literature and in Mathematics;
• A minimum of five different subjects graded either A*-A or the new GCSE grades of 7-9;

	Subject	Examination Type	Examination Board	Predicted Grade

Qualifications Already Taken

	Subject	Level/Examination Board	Results

Subjects To Be Studied At A Level

Please select 3 A Levels you would like to study. Further Maths can be studied as part of a choice of 3 or 4 A Levels.

Please list in order of preference.

Select one of the following* Select one of the following* Select one of the following*

If you are considering taking a fourth subject, please select one from the list below.

Select one of the following If you would like to submit further information for consideration regarding your application, please use the space below.

On submitting your application you will be directed to a confirmation page, you will also receive an email containing a unique identification number. If you do not receive a confirmation email please contact: sixthformadmissions@suttcold.bham.sch.uk.