GEORGE ABBOT SIXTH FORM ADMISSION FORM 2018-2019 Please return this form to: Mrs S Notley, Sixth Form Admission, George Abbot School, Woodruff Avenue, Guildford, Surrey, GU1 1XX Student details: Surname: ______Forename(s): ______

(Please state legal surname if different) Previous UCI NUMBER: ______School: ______ULN NUMBER:______

The above numbers MUST be otained from your current school’s Exams Officer before you submit your application Gender: Male Female Date of Birth: Age on 31/08/18:

Home Address:

Postcode: Home Tel Email: No: Parents/Guardians: Name of Mother/Guardian: ______Daytime Telephone No: ______

Name of Father/Guardian:______Daytime Telephone No: ______In cases where parents are separated, would you, as legal custodian, like copies of student reports Yes/No: and/or general correspondence sent to you to be forwarded to your son/daughter’s other parent? (Please delete as applicable) If yes, please state name and address: (Please indicate if only Reports or both Reports & Correspondence should be sent).

Predicted grades at GCSE: Subject Predicted Grade Subject Predicted Grade English Language English Literature Mathematics Science (add below)

Number of Grades Number of Grades Study Programme Pathway Chosen at A*-B or 9-6? at A*-C or 9-5? (Please refer to Prospectus for further details) Pathway Pathway 4 7 or more A*-B or 9-6 Pathway 3 8 or more A*-C or 9-5 Pathway 2 5 or more A*-C or 9-4 Pathway 1 4 A*-C or 9-4

Please refer to the Subject Guide (available on the school website) for details and entry requirements. Please enter entry requirements as they appear in the Subject Guide and consider these carefully. Chosen subjects (in priority order) Qualification Entry Requirements Type (A level or BTEC) 1 2 3 4 (Pathway 3 + 4 only) Enrichment Option(s)* (please select as least one option) *Please note you may have to retake GCSE English and/or Maths in addition to these options if you achieve less than a grade 4. 1) 2) 3) 4)

Career aim (if known): ______

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Please write about yourself, for example, your interests, achievements, hobbies or positions of responsibility: ______

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Name and address of someone at your current school whom we should contact for a student profile – e.g. Head of Year, Form Tutor etc.

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Has the student any brothers/sisters in George Abbot School? Yes or No (Please delete as applicable) If yes, please state name and year: Name: Name:

This is a firm application and I intend to enter George Abbot Sixth Form on condition of my achieving the required entry grades including those specified for each subject I wish to study.

If no please explain what other options you are considering

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DATA PROTECTION ACTS I understand that, in accepting a place at George Abbot, I give my consent for the School to process my personal data (whether in electronic or paper form). Information you provide on this enrolment form will be passed to the Local Education Authority, Qualifications and Curriculum Authority, DCSF and Connexions which are registered under the Data Protection Act 1998. The registration is primarily for the collection and analysis of statistical data. The School’s full Data Protection Statement can be found on the website.

______(Student) ______(Parent) Date ____/____/2017

FOR OFFICE USE ONLY: Form Received: ………………….. SN for References: …………….. Copy TJR for Interview ……………. Place Offered …………………….. SN Offer letter ………………….. JXM Timetable …………………… SN Admission Number ……….. SN For Filing: ………………….

Please return this application form to: Mrs Sarah Notley, Sixth Form Admissions, George Abbot School, Woodruff Avenue, Burpham, Guildford, GU1 1XX.

Deadline for applications: Friday 1 December 2017 Thank you for your application. Please inform us if your plans change. We will contact you shortly to arrange an interview to discuss your application. Additional Information Ethnic Origin. The Department of Children, Schools and Families (DCSF) request statistical returns from schools on a regular basis throughout the year. Part of the information requested is the ethnicity of students at George Abbot School. To ensure our records are correct, could parents/guardians please tick the box of the appropriate ethnic origin of your son/daughter. These classifications match the requests we receive from the DCSF. The information is used for statistical monitoring only and is held and stored in the strictest confidence. White White/Asian Any other black background  White – British Any other mixed background Chinese  White – Irish Indian Any other ethnic group  White – European Bangladeshi Gypsy/Roma  White – Western European Any other Asian Background Traveller of Irish Heritage  White/Black Caribbean Caribbean Information not yet obtained White/Black African African Parent/pupil prefer not to say  

Religion (please specify)

Is English the first If no, what is the first language language spoken at Yes or No spoken at home? home? If language spoken at home is other than English, would you want your son/daughter to take an exam in the subject? Yes or No (Note the school cannot offer teaching, but can arrange examination entry) Proficiency in English: These classifications match the requests we receive from the DfE. The information is used for statistical monitoring only and is held and stored in the strictest confidence. New to English  Early acquisition  Developing competence  Competent Fluent Not yet assessed   

Pupil Country of Birth (please specify – as stated on passport)

Pupil Nationality (please specify – as stated on passport)

Please note if you have moved or are moving to the UK from abroad you must provide a copy of your child’s passport. If the child is not a British Citizen or EEA National you must also provide a copy of the child’s visa and any relevant home office documentation. Copy passport/Visa attached YES / NO / N/A

Mode of transport to school (please tick relevant box) Public Car Car/Van Bus Walk Share Service Dedicated Train Cycle Taxi School Bus Lunch arrangements (please tick relevant box) Free School Sandwiches Home* School Meal Meal GEORGE ABBOT SCHOOL MEDICAL INFORMATION

BLOCK CAPITALS PLEASE Please return to: Mrs S Notley, Sixth Form Admissions, George Abbot School, Woodruff Avenue, Guildford, Surrey GU1 1XX

Surname: Forename(s):

Date of Birth: DD/MM/YY Form:

Name and address of Family Doctor: Postcode: Tel No:

The Disability Discrimination Act (DDA) 1995 makes it unlawful to discriminate against current or prospective students. I do not Does your son/daughter have a Yes No wish to disability? identify If Yes, Is your son/daughter registered disabled YES / NO

Definition of disability under the DDA ‘A physical or mental impairment which has a substantial and long term adverse effect on a person’s ability to carry out normal day to day activities’.

Please give details of any medical, physical or dietary condition of which the School should be aware and past medical history, especially if it affects participation in physical activities. Condition Details/Type of medication taken Asthma

Epilepsy

Diabetes

Allergy

Migraine

Fainting

Other (please specify)

My son/daughter requires an Emergency Treatment Plan. Yes or No My son/daughter will require assistance with taking a prescribed medicine and I will provide the School with written details on the appropriate form. Yes or No My son/daughter will need to take medication during the School day in the Medical Room, but will not require assistance. I will provide the School with written details on Yes or No the appropriate form. I consent to medical information about my son/daughter being shared with staff on a “need to know” basis. Yes or No

Name of parent/guardian: (Please print) Signed: Date: