© Connell Sixth Form College

CONNELL SIXTH FORM COLLEGE | APPLICATION FORM

Please complete and return your application by Thursday 15 January 2015

PLEASE WRITE IN CAPITAL LETTERS

Surname:

First Name:

Home Address:

Postcode:

Mobile Number:

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Email:

Date of Birth:

Please tick: Male Female

Parents/Carers contact phone:

Parents/Carers contact email:

About You

Could you tell us what you like to do in your spare time.

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Present School:

GCSE Subjects you are taking this year:

Subject Predicted Grade

Any examinations you have already taken:

Subject Grade Achieved

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Proposed Courses you wish to take: If you want to study A Levels please choose four subjects. If you want to study a BTEC please choose one BTEC course Please choose A level subjects from: Art, Biology, Business Studies, Chemistry, Economics, English Language, English Literature, French, Geography, History, Computing/ICT, Law, Mathematics, Further Mathematics, P.E., Philosophy, Physics, Psychology, Religious Studies, Sociology, Theatre Studies, Spanish, Please choose BTEC subjects from Science, Sports Science, Business Studies.

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Career Pathway If you have any idea of what you would like to do after you leave the Sixth Form, please give details below.

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Do you normally receive any extra support with your learning?

Please tick: Yes No

If yes, please give us any details which you feel may be useful

Do you have any long term medical or physical conditions?

Please tick: Yes No

If yes, please give us any details which you feel may be useful.

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Please complete and post your completed application form by Thursday 15 January 2015 to: Admissions Connell Sixth Form College 301 Alan Turing Way Manchester M11 3BS Or by email to: d.percival@connellsixthformcollege.com Thank you for your application form. You will be contacted soon and invited to come for a discussion about your subject choices.

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For Official Use Only: Date and time of interview

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