<p> KENILWORTH SCHOOL SIXTH FORM Application Form 2018/19</p><p>Name: Date of Birth: (PRINT IN FULL) Address: </p><p>Post Code: Gender: Male/Female: Home Telephone No: Student Mobile No: Student e-mail address: Current School: Previous Schools Attended (including Primary School):</p><p>COURSE CHOICE Advanced Level</p><p>Please indicate your course choice in the boxes below – 1, 2, 3, & 4 in order of preference. You should also indicate a reserve choice by writing a letter R against the fifth choice.</p><p>Applied Science BTEC Graphic Design Art History Modern Biology History Early Modern BTEC National in Sport Latin Business Mathematics Chemistry Mathematics with Further Maths Computer Science Music Drama & Theatre Studies Music Technology Economics Physical Education English Combined Physics English Language Politics English Literature Product Design 3D Fashion & Textiles Psychology French Religious Studies Geography Sociology German Spanish Please turn over and complete the rest of this form Subject GCSE’s Estimated Grade Results (please list) (please leave blank – unless already received)</p><p>Additional Information Use your Record of Achievement to help you complete this section. This is an opportunity to tell us more about yourself. For example, have you received any awards for sporting/academic achievement etc? Are you involved in any clubs or groups out of school? </p><p>Please continue on a separate sheet, if necessary.</p><p>What plans do you have for the future?</p><p>Considerations for Special Exam Conditions and any Medical Information you consider we should be aware of: </p><p>Please return your completed application form to:</p><p>Mr Nick Mummery, ([email protected]) Senior Deputy Head / Head of Sixth Form, Rouncil Lane, Kenilworth, Warwickshire, CV8 1FN</p><p>The priority application deadline is Friday 15 December 2017; Please Note: large letter rate is required if returning by post. Thank You FOR ADMIN USE ONLY: Date Application Received: Entered on SIMS: References Requested: Entered on Options: References Received: Interview Date: Conditional place offered:</p>