WHITBY COMMUNITY COLLEGE SIXTH FORM

APPLICATION FORM, 2009

Personal Details

Your Name: ………………………………………………………………………………………………………………………………………

Tutor Group (if a current student at WCC): …………………………………………………………

Address: ……………………………………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………………………………………………

………………………………………………………………………… Post Code: …………………………………………………………

Date of Birth: ……………………………………………………………………………………………………………………………………

Home Telephone No: …………………………………………………………………………………………………………………………

Courses/Subjects you would like to take - please list the subjects/courses in preference order: (Please note: at WCC we operate a study policy in relation to advanced courses where we expect students to select four AS or equivalent.)

Subject Course and Level
1
2
3
4
5

What do you want to do next year? Put 1 for your first choice and 2 for your second choice.

o WCC o Apprenticeship or job o FE College o Sixth Form College o Armed Forces OR o moving away

(please tick if applicable)

Please note that places will be offered subject to satisfactory references and grades.

Learning Difficulties and/or Disability (please tick):

1. I consider myself to have a learning difficulty or a disability or a health problem. o

If so, please provide details below:

2. I do not consider myself to have a learning difficulty or a disability or a health problem. o

Ethnicity (please tick) o Bangladeshi o Black Other o White British o Indian

o Chinese o White Irish o Pakistani o White and Asian o White Other

o Asian Other o White and Black African o Other o Black African o White and Black

o Caribbean o Black Caribbean o Mixed Other o Not known/provided

New to the College? If you are applying from another school, please provide the following details:

Name of your current school: …………………………………………………… Tel No: ………………………………………………………

Address of current school: …………………………………………………………………………………………………………………………………

……………………………………………………………………………………………… Post code: ……………………………………………………

Name of your Head of Year: ………………………………………………………………………………………………………………………………

Data Protection Act 1998: The information you provide on this form will be passed to the Learning and Skills Council (the LSC). The LSC is responsible for funding and planning education and training for young people and adults in England, and is registered under the Data Protection Act 1998. The information you provide will be shared with other organisations for the purpose of administration, careers and other guidance, and statistical and research purposes. Other organisations with which we share information include the Department for Education and Skills, Connexions, educational institutions and organisations performing research and statistical work on behalf of the LSC or its partners. The LSC is also a co-financing organisation and uses European Social Funds from the European Union to directly or indirectly part-finance learning activities, helping develop employment by promoting employability, business spirit and equal opportunities, and investing in human resources. Further information about partner organisations and what they do, may be found at http://www.lsc.gov.uk, and by following the links to data protection.

Student Declaration:

I confirm the information given on this form is true, complete and accurate.

Signature: ______Date: ______