Personal Details s16

Sixth Form Application Courses starting September 2017 Personal Details Name Enter name Date of Birth: Enter a date : Email Address: Enter email Phone Number: Enter number Address: Enter address including postcode Parent/ Carer name: Enter name Contact Number: Enter number

Academic Information Current School: Enter text Attendance: Enter attendance as a percentage GCSE: English Language Grade GCSE: Mathematics Grade Further Qualifications Subject Grade Subject Grade Enter subject Enter grade Enter subject Enter grade Enter subject Enter grade Enter subject Enter grade Enter subject Enter grade Enter subject Enter grade Enter subject Enter grade Enter subject Enter grade Enter subject Enter grade Enter subject Enter grade Enter subject Enter grade Enter subject Enter grade

Interests We are interested in developing all aspects of our students. Please outline below any hobbies or interests you have.

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Priority We are aware that students apply to a number of institutions. For planning purposes it would help if you could indicate your priority of study with us. Springwest Academy represents my please select of study. Course Selection Please be aware of the following:- . We may be unable to offer all of the subjects listed below owing to class size. . After the timetable has been created certain subject combinations will not be possible. . You may select a maximum of 4 courses. . This form represents an expression of interest only, final subject choices will be made in consultation with our staff during your admissions interview. Springwest Campus Logic Campus Wider consortium ☐ English Literature ☐ Spanish ☐ Sociology ☐ French ☐ Business Events (BTEC) ☐ Psychology ☐ History ☐ Business Accounting (BTEC) ☐ Politics ☐ Geography ☐ Digital Design (BTEC) ☐ Law Performing ☐ Arts ☐ Fine Art ☐ Mathematics ☐ Biology ☐ Chemistry ☐ Physics

Reference All external candidates will require an academic reference. Please give details of your referee below

Name: Enter name Email Address: Enter email Phone Number: Enter number Address: Enter address

Please submit your completed application form to [email protected] Successful applicants will be invited to interview following GCSE results day in August 2017.