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Sixth Form Application Form APPLICATION FOR FULL TIME SIXTH FORM EDUCATION For pupils in Harrow high schools starting 2013 Bentley Wood High School Hatch End High School Salvatorian College Bridges Road, Stanmore Headstone Lane, Harrow High Rd, Harrow Weald, Harrow Middlesex HA7 3NA Middlesex HA3 6NR Middlesex HA3 5DY Tel: 020 8954 3623 Tel: 020 8428 4330 Tel: 020 8863 2706 Email: [email protected] Email: [email protected] Email: [email protected] www.bentleywood.harrow.sch.uk www.hatchend.harrow.sch.uk www.salvatorian.harrow.sch.uk Canons High School Kingsley High School Shaftesbury High School Shaldon Road, Edgware Whittlesea Road, Harrow Weald Headstone Lane, Harrow Middlesex HA8 6AN Middlesex HA3 6ND Middlesex HA3 6LE Tel: 020 8951 5780 Tel: 020 8421 3676 Tel: 020 8428 2482 Email: [email protected] Email: [email protected] Email: [email protected] www.canonshighschool.org.uk www.kingsley.harrow.sch.uk www.shaftesbury.harrow.sch.uk Harrow College Nower Hill High School Stanmore College Harrow on the Hill Campus George V Avenue Elm Park, Stanmore Lowlands Road, Harrow, Middlesex HA1 3AQ Pinner HA5 5RP Middlesex HA7 4BQ Tel: 020 8909 6000 Tel: 020 8863 0877 Tel: 020 8420 7700 Email: [email protected] Email: [email protected] Email: [email protected] www.harrow.ac.uk www.nowerhill.harrow.sch.uk www.stanmore.ac.uk Harrow College Park High School Whitefriars Training Centre Harrow Weald Campus Thistlecroft Gardens, Stanmore Unit 1, Whitefriars Industrial Estate Brookshill, Harrow Weald Middlesex HA7 1PL Tudor Road, Wealdstone HA3 5PQ Middlesex HA3 6RR Tel: 020 8952 2803 Tel: 020 8909 6000 Tel: 020 8909 6000 Email: [email protected] Email: [email protected] Email: [email protected] www.parkhighstanmore.org.uk www.harrow.ac.uk www.harrow.ac.uk Rooks Heath College Whitmore High School Harrow High School Eastcote Lane, South Harrow Porlock Avenue, Harrow Gayton Road, Harrow Middlesex HA2 9AG Middlesex HA2 0AD Middlesex HA1 2JG Tel: 020 8422 4675 Tel: 020 8864 7688 Tel: 020 8861 7300 Email: [email protected] Email: [email protected] Email: [email protected] www.rooksheath.harrow.sch.uk www.whitmore.harrow.sch.uk www.harrow-high.harrow.sch.uk Sacred Heart Language College Harrow Skills Centre High St, Wealdstone, Harrow Kenmore Avenue, Kenton Middlesex HA3 7AY Middlesex HA3 8LU Tel: 020 8863 9922 Tel: 020 8420 8810 Email: [email protected] Email: [email protected] www.sacredheartgirls.harrow.sch.uk www.harrow.ac.uk HOW TO COMPLETE THIS FORM WHAT HAPPENS NEXT FINANCIAL SUPPORT FOR STUDENTS You should only complete one form and Your application will be acknowledged The 16-19 Bursary scheme is designed to make one application. Please fill in all the and then you will be given a guidance help support young people who face the sections of the form clearly. Use black ink interview by your preferred provider. greatest financial barriers to participation and print your personal details in block in education of training. For more capitals. The outcome of your first application will information see www.education.gov.uk or be notified by the first day of the summer ask your school or college. Remember, you will need a referee from term. If your first choice college or school your school to complete section four of sixth form does not offer you a place, TUITION FEES - HOME STUDENTS the application form. If you submit your your application will be passed to your Home students aged 16-18 are not application form without a reference, it second choice. normally charged fees for Registration, will be returned to you for completion. The providers make every effort to give Tuition or first sitting of Examinations. Please remember to sign the form which guidance which ensures that you are TUITION FEES - OVERSEAS must also be signed by your parent/ placed on a programme of study that STUDENTS guardian. best suits your needs. The offer of a place is conditional on your achieving the All overseas students will pay registration, For details of the courses provided by appropriate entrance qualification, details tuition and examination fees. Contact the Harrow Sixth Form Collegiate please of which are indicated in the course your preferred provider for the tariff. contact one of the Collegiate members: information from each provider, and will be made clear at interview or your The information on this application • Bentley Wood High School letter of offer. Every effort will be made will form the basis of a computer • Canons High School to place you on an alternative course record. Details of the uses to which the • Harrow College in September if you do not meet the information will be put are available from - Harrow on the Hill Campus conditions of your original offer. the reception desk in each institution. - Harrow Weald Campus - Whitefriars Training Centre If you change your first preference of DATA PROTECTECTION • Harrow High School institution before your interview, you • Hatch End High School must write to the institution - signed by The information you provide will be used • Nower Hill High School yourself and your parent/guardian. by The Collegiate for the sole purpose • Park High School of course application administration and • Rooks Heath College STUDENTS WITH LEARNING associated correspondence. At no time • Sacred Heart language College DIFFICULTIES AND DISABILITIES will your personal information be passed • Salvatorian College to other organisations for marketing, • Stanmore College The providers are committed to providing sales or any other purpose. • Whitmore High School maximum opportunities for all students. Information on provision is contained in WHERE AND WHEN TO SEND THIS a Disability statement available at each FORM institution. Your form will be completed by your Each provider has a co-ordinator for school and sent directly to your preferred students with specific learning difficulties provider by the closing date Wednesday and or disabilities. 13th February 2013. Applications after this date will be considered according to There are clearly established links availability. 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. FOR OFFICE USE only HARROW SIXTH FORM COLLEGIATE Full-time Application Form 2013/4 Please number your 3 chosen colleges or school sixth form in order of your preference: STANMORE COLLEGE To enable us to support you please tick box as appropriate. If you think you have a: HARROW COLLEGE: Disability HARROW ON THE HILL CAMPUS Learning Difficulty HARROW WEALD CAMPUS Health Problem WHITEFRIARS TRAINING CENTRE Please give details - Disability: HARROW SKILLS CENTRE Visual Impairment - 01 SCHOOL SIXTH FORM Disability affecting Mobility - 03 (Nominate School) Other Medical Condition - 05 Mental Health Difficulty - 07 Hearing Impairment - 02 Other Physical Disability - 04 1. PERSONAL DETAILS Emotional or Behavioural Difficulty - 06 Temporary Disability - 08 Surname Profound complex Disability - 09 First Names Aspergers Syndrome - 10 Gender: Male Female Date of Birth Multiple Disabilities - 90 Address Other - Please State - 97 Please give details - Learning Difficulty: Moderate Learning Difficulty - 01 Severe Learning Difficulty - 02 Post Code Dyslexia - 10 Home Telephone No Dyscalculia - 11 Mobile Other Specific Learning Difficulty - 19 Email Autism Spectrum Disorder - 20 Local Authority Multiple Learning Difficulties - 90 Other - Please State - 97 Middle/Junior School Dates Please give details of support required: 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. Have you been resident in the UK for the last 3 years? It will not affect your chances of a place. I consider my ethnic origin to be (please 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 Any Other White Background - 34 White & Black Caribbean - 35 Do you regard English as your second language? White & Black African - 36 Yes No White & Asian - 37 Any Other Mixed/Multiple Ethnic Background - 38 FOR OFFICE USE only Indian - 39 If yes, what is your first language? Pakistani - 40 Bangladeshi - 41 Chinese - 42 Parent/Guardian Surname Any Other Asian Background - 43 Forename African - 44 Title Caribbean - 45 Any Other Black/African/Caribbean Background - 46 Daytime Telephone Mobile Arab - 47 Email Any Other Ethnic Group - 98 2. COURSE APPLIED for A) Course and subjects applied for B) Alternative choices C) Do you intend to go into Higher Education? Yes No D) What is your career aim? 3. 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 achieved predicted etc. if completed if result not yet known 4. REFERENCE to BE completed By THE SCHOOL REFEREE General Assessment Outstanding Good Satisfactory Unsatisfactory (please tick appropriate boxes) Academic achievement 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 OF APPLICANT AND parent/guardian 5.
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