IC6 Application Form 2020-21

STUDENT Legal Surname

Legal Forename

Preferred Name

Date of Birth

Home Phone

Mobile number Email address Address Line 1 Address Line 2 Address Line 3 Postcode Country Please make known any physical conditions, allergies, medications etc…

Do you currently have a statement of Special Educational Needs or do you receive any support in class or with

exams?

If you answered 'yes' please describe (e.g. dyslexia) and detail the support

Nationality

Ethnicity

Dominant home language

PARENT/GUARDIAN Relationship Title Name Phone number Email address Country where you normally reside CURRENT SCHOOL Present School

Your Tutor’s name

Address of School

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QUALIFICATIONS Please list the qualifications that you have achieved. If you have not yet sat your Year 11 exams please detail your estimated grades GCSE Subject Predicted Grade or Achieved Grade

COURSES Please detail which A level or vocational courses you are interested in studying

Choice 1

Choice 2

Choice 3

Choice 4

Please detail which IC6 school you would like to be based at o Central Foundation Boys’ School o Highbury Fields School o City of London Academy Highbury Grove o City of London Academy Islington

If you don’t have a preference leave this blank)

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Please detail any work experience or part-time employment you have undertaken

Please tell us about which careers or university subjects you are considering

PERSONAL STATEMENT Tell us about your achievements, skills, your interests and spare time activities and the reasons for your choice of career or university subjects after you leave IC6

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I understand that the Islington Sixth Form Consortium schools (consisting of Central Foundation Boys’ School, City of London Academy Highbury Grove, City of London Academy Islington and Highbury Fields School) will handle the information I have provided in line with the provisions of the Data Protection Act 1998 and the General Data Protection Regulation (GDPR). Any personal information will be held in confidence with only the necessary people able to see or use it.

Find out more about how we process personal data about you or your child by reading our privacy notices at www.ic6.co.uk.

I also understand that the Islington Sixth Form Consortium schools may also use my details to contact me about post-16 events that may be held by any of the IC6 schools.

I agree for the data I have provided to be used in accordance with the IC6 privacy notices.

I would like to receive newsletters or other information about IC6 open days and events via email.

Applicants Signature Date

Please return the completed application form to [email protected] or Islington Sixth Form Consortium (IC6), c/o Central Foundation Boys’ School, Cowper Street, London, EC2A 4SH

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