SIXTH FORM APPLICATION

2018 – 2019

Student Details
Surname: / Forename(s):
Address: / Date of Birth:
Home Tel No:
Student Mobile No:
Parent Mobile No:
Postcode: / Male / Female:
Current/Previous School: / Headteacher:
Name of Parent/Carer:
Student Personal Email (not a school one):
Parent Email:
Do you have any physical, medical or learning difficulties for which you may need additional support? / YES / NO
(please attach details if ‘YES’)
A-Levels
MathematicsP.E.
English LiteratureGeography
ChemistryHistory
PhysicsMusic
BiologyBusiness
FrenchPsychology
Computer SciencePhilosophy & Ethics
DramaSpanish
Art / Vocational Qualifications
(equivalent to 1 A Level)
National Subsidiary Diplomas
BTEC Applied Science
BTEC Business
BTEC Creative Digital Media
BTEC Sport
BTEC Health and Social Care
BTEC Performing Arts / Extended Diploma
(equivalent to 3
A-Levels or 3 National Subsidiary Diplomas)
BTEC Health & Social
Care
BTEC Childcare

Please note that, while we make every effort to provide the full range of courses on offer, we reserve the right to add, change or cancel course offers at any time depending on take up and the availability of resources

I wish to undertake the following route: A-Levels Vocational Extended

(You can mix A-Level & Vocational subjects)

Subject Choices
Please indicate three courses that you would like to study in preference order and at least one reserve subject(A-Level & Vocational routes). (Note: in exceptional circumstances we may consider four subjects)
First Preference:
Second Preference:
Third Preference:
Reserve Subject (1):
Reserve Subject (2):

If your grades do not meet our criteria we may well be able to offer you a Foundation route which is for One Year. If successful it can allow you to undertake further Level 3 courses. This involves GCSE resits in English and/or Maths and a BTEC National Certificate which is equivalent to 1 AS Level. BTEC subjects might include:

  • Applied Science
  • Business
  • Health & Social Care
  • Sport

GCSE Exams studied and results (estimated and/or actual)

Subject / GCSE
 / BTEC
 / Estimated Grade / Actual Grade
Give details of the additional examinations taken, e.g. Music, DoE etc.
Please give details of your future career plans (if known)
Where / how did you find out about Abraham Darby Academy?
Open Evening / Advert
Know an existing student
Bus
Other (please state)
Ethnic Information (please tick). Used for statistical purposes only
White – British / Any other mixed background / Black – Caribbean
White – Other / Asian – Indian / Black – African
White & Black Caribbean / Asian – Pakistani / Chinese
White & Black African / Asian – Bangladeshi / Any other Ethnic Group (please state)
White & Asian / Asian - Other
Nationality Used for statistical purposes only
Signature: / Date:

Please return your application by 8th January 2018 to:-

Mr N Robins, Head of Sixth Form
Abraham Darby Academy
Ironbridge Road
Madeley
Telford TF7 5HX / Mrs Julie Pettifer, Sixth Form Administrator
Tel: 01952 386056

Email :