Sixth Form Online Application

The Pingle Academy Sixth Form - Application closing date: Friday 27th November 2020

Head of Sixth Form - Ms J Wilson (jwilson.pingle@deferrerstrust.com)

PLEASE NOTE: Stars (*) next to questions mean that this is required information, you will not be able to submit the form unless this is complete. Question marks (?) underneath text boxes give you tips and examples to complete the the form.

Student Details

Forenames* Surname* Date of Birth*

Please select one of the following*MaleFemale

Home Address* Postcode* Home Telephone Number Mobile Telephone Number* E-Mail Address* Current School* Current Form Group

Parent/Carer Details

Parent/Carer A

Name* Home Address (if different than above) Postcode Home Telephone Number Mobile Telephone Number* E-Mail Address*

Parent/Carer B

Name Home Address (if different than above) Postcode Home Telephone Number Mobile Telephone Number E-Mail Address

Qualifications

GCSE (AND OTHER COURSES) FORECAST GRADES FOR ALL SUBJECTS INCLUDING ALL SCIENCES. PLEASE INDICATE SHORT COURSES.

	Subjects	Qualification Type	Predicted Grade

QUALIFICATIONS/CERTIFICATES/AWARDS ALREADY ACHIEVED (INCLUDING OUT OF SCHOOL e.g. Duke of Edinburgh)

	Subject	Qualification Type	Additional Info

Pathway

Please select your chosen pathway below*Pathway 1: A Level only (select 3 A Level subjects)Pathway 2: Academic — a combination of A Level and Vocational qualifications (select 1 A Level and 2 BTECs or 2 A Levels and 1 BTEC).

Choice of subjects

Please choose 3 subjects, one from each list in order of preference from the options below. You will be able to discuss these options at interview.

What are the reasons for your subject choices

	Subject	Reason for choice	Additional Info
Option A
Option B
Option C
Option D

Please check any of the following subjects if you are interested in themTheatre StudiesFrenchSpanishMusic

If you have researched a particular career or career area, please tell us what your plans are, including any Higher Education plans Briefly describe your interests and hobbies/work experience or any part-time employment you have had* To help us to help you, please give details of any medical (e.g. physical impairment/disability), additional learning needs you may have (e.g. dyslexia) or any special arrangements for examinations

Interviews will be held between 25 January and 4 February 2021

My preferred dates and times are (please select below)

Please select up to 3 different days

	15:30 - 17:00	17:00 - 18:00	18:00 - 19:00
Monday 25th January
Tuesday 26th January
Wednesday 27th January
Thursday 28th January
Monday 1st February
Tuesday 2nd February
Wednesday 3rd February
Thursday 4th February

Please contact Ms Wilson, Head of Sixth Form, if the above dates are not convenient.

Email - jwilson.pingle@deferrerstrust.com

Declaration

By checking this box you agree that all of the information you have entered is true to your knowledge*Yes, I agree