6 th Form Application 2012/2013 Entry

Transcription

1 Early Submission of this application is recommended due to the limited number of places 6 th Form Application 2012/2013 Entry Head of 6 th Form: Mrs L Humber Please complete all sections of the application form and return to: Mrs Lyn Wright P.A. to Head of 6 th Form The Langley Academy Langley Road Slough Berkshire SL3 7EF Phone: Please attached a passport sized Fax: photograph of yourself. 6 th Form@langleyacademy.org All application forms must be signed by applicant and parent/guardian Details of student Legal surname / family name: Legal first name: Date of birth: (dd/mm/yy) Home address House number/name: Town: Gender: M / F (please circle) Street: County: Post Code: Home phone number: Mobile phone number (student): (student): Details of parent/guardian (s) Title: Dr/Mr/Mrs/Ms First Name Surname/family name Home phone number: Work phone number: Mobile phone number (Parent/Guardian): (Parent/Guardian) Address (if not the same as student s home address) Relationship to child: The Langley Academy 6 th Form Application Form 1

2 Course Choices International Baccalaureate: Please circle the subject you would like to study in each of the groups AND indicate whether this would be at HIGHER or STANDARD level. Remember, you MUST indicate 3 subjects at HIGHER level and 3 at STANDARD level. We are unable to accommodate the combination of German and Mathematics Higher. If you wish to study German, you must take either Mathematical Studies or Mathematics Standard. Subjects to choose from one in each group Extra guidance HIGHER OR STANDARD Group 1 Group 2 Group 3 Group 4 Group 5 Group 6 Language A Language B Individuals and Society Experimental Sciences Mathematics Arts and Electives English SL French Economics Biology Mathematical Visual Arts German (Standard Geography Chemistry Studies Chemistry Only) History Physics Mathematics Spanish Psychology Standard French ab inito Mathematics Higher An ab inito language is for beginners (not previously studied) in that language and it counts as a standard level subject Maths Studies counts as a standard level subject OR A Levels OR Btec (National/Award/Certificate) AS/A2 Levels. Choose three or four from: Art Biology Business Studies Chemistry Drama & Theatre Studies Economics English Literature Film Studies French Further Maths Geography History ICT Law Mathematics Media P.E. Physics Philosophy & Ethics Product Design Psychology Religious Studies Sociology Choice 1 Choice 2 Choice 3 Choice 4 Please add any other courses you would be interested in: BTEC National Diploma Equivalent to 3 A levels taken on its own Business Sport OR Please Tick BTEC National Certificate Equivalent to 2 A levels may be taken with 1 AS level Business Please Tick Health & Social Care OR BTEC National Award Equivalent to 1 A level may be taken with 2 AS levels Please Tick Applied Science The Langley Academy 6 th Form Application Form 2

3 Examination Results Examination results gained and or examinations to be taken Date of Exam Exam Board (Edexcel, AQA etc) Subject Qualification (GCSE, BTEC, etc) Grade predicted Grade achieved EXTERNAL STUDENTS ONLY - Please ask your current school for your: UPN number UCI number Previous Education Please list previous schools attended with dates. Use the right hand column to give details of any special education provision or needs etc School (name and address) From (DD/MM/YYYY) To (DD/MM/YYYY) The Langley Academy 6 th Form Application Form 3

4 Personal Statement please continue on a separate sheet if required Please indicate your reasons for choosing your course or subject (including careers and universities you have considered or are considering): Please indicate your personal interests and achievements: Any other information you wish to give: The Langley Academy 6 th Form Application Form 4

5 Equal Opportunities Monitoring Please indicate by placing a tick in the box next to the description which you feel most closely describes your ethnic origin. This information is collected on behalf of the Department of Education for their statistical use in the monitoring of equal opportunities. 11 Asian or Asian British - Bangladeshi 19 Mixed White and Asian 12 Asian or Asian British - Indian 20 Mixed White and Black African 13 Asian or Asian British - Pakistani 21 Mixed White and Black Caribbean 14 Asian or Asian British Other Asian 22 Mixed any other 15 Black or Black British - African 23 White - British 16 Black or Black British - Caribbean 24 White - Irish 17 Black or Black British Other Black 25 White Other White 18 Chinese or Chinese British 26 Other ethnic group Funding Eligibility What is your nationality (e.g. as stated in your passport)?.. What is your first language? What language/s are spoken at home? Have you been a permanent resident in the UK or EU for the past 3 years? Yes/No (please circle) Date of entry to UK if not born here:.. Is there any restriction on the time you may stay in the UK? Yes/No (please circle) If yes please give details: Equity Statement Do you have a disability, medical condition, learning difficulty or learning needs which we need to be aware of in order to provide support (please tick box)? Wheelchair user Hearing impairment Visual impairment Speech difficulty Mental health issues ADHD Aspergers Autism/Autistic spectrum Dyslexia English as an additional language Other condition which significantly affects daily life (please specify): Data Protection Act: The information that you have given on this form will be held on Academy files, including computer files and may be used for statistical purposes within the Academy and may be shared with schools, local authorities and funding bodies. In signing this application you are giving your consent to us to use this data and share information on your progress with your parent/guardian. Signature of Applicant:. Date: Parent/Guardian Have you discussed the proposed course with your daughter/son/ward? YES / NO (please circle) I support this application and will ensure Academy regulations will be followed: Signature of Parent/Guardian: Date:... The Langley Academy 6 th Form Application Form 5

6 TLA AS Entry Requirements The whole picture: 5A* - C Grades including English Grade C & Maths Grade C Grade Mainly A* - B at GCSE Mainly B s and above at GCSE Mainly C s & above at GCSE and/or BTEC Mainly C s & below at GCSE and/or BTEC Mainly D s/e s at GCSE and/or BTEC Students should consider IB 4 A Levels 3 A Levels or BTEC paired with AS Level BTEC Extended Diploma (equivalent to 3 A Levels) BTEC First Diploma (equivalent to GCSE) Prerequisites: International Baccalaureate Diploma Programme please enquire for further information AS Level Maths and English grade C, however, a grade B is necessary to continue with certain A Levels, listed below: A Level Subject Further Maths Maths Chemistry and Physics Biology English Economics, Law, Psychology, Sociology French GCSE Prerequisite Maths A-A* Maths B Science B and Maths B Science B and English B English Language C and English Literature B or English Language B English B French B BTEC qualification: BTEC Qualification Any Extended Diploma (eq 3 A Levels) GCSE Prerequisite English C & any BTEC at Merit The Langley Academy 6 th Form Application Form 6