APPLICATION FOR FULL TIME SIXTH FORM EDUCATION For pupils in Harrow high schools starting 2021/22 Bentley Wood High School Kingsley High School Shaftesbury High School Clamp Hill, Stanmore Whittlesea Road, Harrow Weald Headstone Lane, Harrow Middlesex HA7 3JW Middlesex HA3 6ND Middlesex HA3 6LE Tel: 020 8954 3623 Tel: 020 8421 3676 Tel: 020 8428 2482 Email: [email protected] Email: [email protected] Email: [email protected] www.bentleywood.harrow.sch.uk www.kingsley.harrow.sch.uk www.shaftesbury.harrow.sch.uk Canons High School Nower Hill High School Stanmore College Shaldon Road, Edgware George V Avenue Elm Park, Stanmore Middlesex HA8 6AN Pinner HA5 5RP Middlesex HA7 4BQ Tel: 020 8951 5780 Tel: 020 8863 0877 Tel: 020 8420 7700 Email: [email protected] Email: [email protected] Email: [email protected] www.canonshighschool.org.uk www.nowerhill.org.uk www.stanmore.ac.uk Harrow College Park High School Whitefriars School Harrow on the Hill Campus Thistlecroft Gardens, Stanmore Whitefriars Avenue Lowlands Road, Harrow, Middlesex HA1 3AQ Middlesex HA7 1PL Harrow Tel: 020 8909 6000 Tel: 020 8952 2803 Middlesex HA3 5RQ Email: [email protected] Email: [email protected] Tel: 020 8427 2080 www.harrow.ac.uk www.parkhighstanmore.org.uk Email: [email protected] www.whitefriarssecondary.net Harrow High School Pinner High School Gayton Road, Harrow Beaulieu Drive, Pinner Whitmore High School Middlesex HA1 2JG Middlesex HA5 1NB Porlock Avenue, Harrow Tel: 020 8861 7300 Tel: 020 3096 0769 Middlesex HA2 0AD Email: [email protected] [email protected] Tel: 020 8864 7688 www.harrowhigh.com www.pinnerhighschool.org Email: [email protected] www.whitmore.harrow.sch.uk Hatch End High School Rooks Heath College Headstone Lane, Harrow Eastcote Lane, South Middlesex HA3 6NR Harrow Middlesex HA2 Tel: 020 8428 4330 9AG Email: [email protected] Tel: 020 8422 4675 www.hatchend.harrow.sch.uk Email: [email protected] www.rooksheath.harrow.sch.uk FOR OFFICE USE ONLY Full-time Application Form 2021/22 Please number your chosen colleges or schools sixth form in order of your preference: HARROW COLLEGE: To enable us to support you please tick box as appropriate. If you think you have a: HARROW ON THE HILL CAMPUS Disability Please give details - Learning Difficulty: HARROW WEALD CAMPUS Learning Difficulty Moderate Learning Difficulty - 01 STANMORE COLLEGE Health Problem Severe Learning Difficulty - 02 SCHOOL SIXTH FORM Dyslexia - 10 Please give details - Disability: (Nominate School) Dyscalculia - 11 Visual Impairment - 01 Other Specific Learning Difficulty - 19 Disability affecting Mobility - 03 Autism Spectrum Disorder - 20 Other Medical Condition - 05 Multiple Learning Difficulties - 90 Mental Health Difficulty - 07 Other - Please State - 97 Hearing Impairment - 02 Other Physical Disability - 04 Emotional or Behavioural Difficulty - 06 1. PERSONAL DETAILS Temporary Disability - 08 Profound complex Disability - 09 Surname Aspergers Syndrome - 10 First Names Multiple Disabilities - 90 Gender: Male Female Date of Birth Other - Please State - 97 Nationality Country of Birth Please give details of support required: Address Post Code Home Telephone No Student Mobile Student Email Local Authority Middle/Junior School Dates High School Dates Any disclosure of disability will be used only to help ensure that reasonable College arrangements are made to support you on your course. Dates Please help us to monitor our equal opportunities policy by filling in this section. It will not affect your chances of a place. I consider my ethnic origin to be (please Have you been resident in the UK for the last 3 years? tick appropriate box): Yes No English/Welsh/Scottish/Northern Irish/British - 31 If no, what is your country of origin? Irish - 32 If no, what is your date of entry into the UK? Gypsy Or Irish Traveller - 33 Do you regard English as your second language? Any Other White Background - 34 White & Black Caribbean - 35 Yes No White & Black African - 36 If yes, what is your first language? White & Asian - 37 Any Other Mixed/Multiple Ethnic Background - 38 Parent/Guardian Surname Title Indian - 39 Pakistani - 40 Forename Bangladeshi - 41 Daytime Telephone Mobile Chinese - 42 Email Any Other Asian Background - 43 African - 44 2nd Parent/Guardian Surname Title Caribbean - 45 Forename Any Other Black/African/Caribbean Background - 46 Arab - 47 Daytime Telephone Mobile Any Other Ethnic Group – 98 Email Religion: 2. WHAT IS YOUR CAREER AIM? 3. COURSE APPLIED FOR Course and subjects applied for Type GCSE, A Level, BTEC etc. Alternative choices: 4. QUALIFICATIONS Please give details of any qualifications already obtained, exams still to be taken or courses completed. Predicted grades to be entered by school/ college referee. Subject or Course Type Full/Short Date Grade Grade GCSE, A Level of Award achieved predicted BTEC etc. if completed if result not yet known 5. REFERENCE TO BE COMPLETED BY THE SCHOOL REFEREE General Assessment Outstanding Good Satisfactory Unsatisfactory (please tick appropriate boxes) Attitude to academic work Meeting assignment deadlines General conduct Attendance (%) Punctuality (%) Student recommended for chosen course: Yes No If yes, please state why you feel the applicant is suitable for his/her chosen programme of study. If no, please recommend an appropriate course. I confirm that the predicted grades entered are correct: Signed Position 6. SIGNATURES OF APPLICANT AND PARENT/GUARDIAN COLLEGE/SCHOOL STAMP Signature of parent/guardian Date Signature of applicant Date HOW TO COMPLETE THIS FORM WHAT HAPPENS NEXT FINANCIAL SUPPORT FOR STUDENTS You should only complete one form and The outcome of your first application will The 16-19 Bursary scheme is designed to make one application. Please fill in all the be notified by the first day of the summer help support young people who face the sections of the form clearly. Use black ink term. If your first choice college or school greatest financial barriers to participation and print your personal details in block sixth form does not offer you a place, in education of training. For more capitals. your application will be passed to your information see www.education.gov.uk or second choice. Remember, you will need a referee from ask your school or college. your school to complete section four of The providers make every effort to give TUITION FEES - HOME STUDENTS the application form. If you submit your guidance which ensures that you are application form without a reference, it placed on a programme of study that Home students aged 16-18 are not will be returned to you for completion. best suits your needs. The offer of a normally charged fees for Registration, place is conditional on your achieving Tuition or first sitting of Examinations. Please remember to sign the form which the appropriate entrance qualification, must also be signed by your parent/ details of which are indicated in the TUITION FEES - guardian. course information from each provider, OVERSEAS STUDENTS For details of the courses provided please and will be made clear at interview or your letter of offer. Offers may need to be All overseas students will pay registration, see our prospectus. renegotiated if there is a lack of demand tuition and examination fees. Contact WHERE AND WHEN TO SEND for the course. Every effort will be made your preferred provider for the tariff. to place you on an alternative course THIS FORM The information on this application in September if you do not meet the will form the basis of a computer Your form will be completed by your conditions of your original offer. record. Details of the uses to which the school and sent directly to your preferred information will be put are available from provider by the closing date Friday 5th STUDENTS WITH LEARNING the reception desk in each institution. February 2021. Applications after this DIFFICULTIES AND date will be considered according to DISABILITIES DATA PROTECTION availability. The providers are committed to providing The information you provide will be used maximum opportunities for all students. by The Collegiate for the sole purpose Information on provision is contained in of course application administration and a Disability statement available at each associated correspondence. At no time institution. will your personal information be passed Each provider has a co-ordinator for to other organisations for marketing, students with specific learning difficulties sales or any other purpose. and or disabilities. There are clearly established links between colleges, high schools and local authorities to facilitate the transition of students. Contact your preferred provider with regard to physical access in respect of your chosen course. To assist the providers please indicate if you have a special educational need by providing as much detail as possible on the relevant section of the application form..