Application Form. Personal details. Education details YEAR OF ENTRY 2019

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1 Application Form Please read through the whole of this form before completing it in BLACK INK Please return to: Sixth Form Office, Banbury Academy, Ruskin Road, Banbury, OX16 9HY This form is to be used for all students wishing to apply to Banbury Aspirations Campus Sixth Form: Wykham Park Academy or Space Studio School Banbury Personal details YEAR OF ENTRY 2019 Surname:... Forename: Middle name(s):... Date of Birth:.... Address: Post Code:.... Home Tel No: Student s Student s Mobile:.... Parent / Carer Names:.... Parent / Carer Contact details: address:... Mobile Tel No:.Work Tel No:.. Contact information provided will only be used for the Sixth Form application process. Including setting up interviews, taster day information and subject choices in the Sixth Form. If you do not enrol at the Sixth Form on results day, your information will be deleted. If your application is successful, the details you provide may be used, during your time in the Sixth Form, to contact you or your parents with information relevant to your studies and opportunities. If you agree to the school contacting you please tick here. Will you be living at your current address in September? YES / NO Education details Please give details of your current secondary school/college School/College: Full Address:.... Attended from: To:

2 My Qualifications GCSEs, BTEC First Diplomas and other qualifications Please tick the subjects you are taking and indicate your predicted grade, if known. Possible predicted grade values for GCSE are A*, A, B, C, D, E, F, G or 9-1 Possible predicted grade values for BTEC First Diplomas are Distinction (D), Merit (M), Pass (P), Fail (F). Add other subjects if not listed. Predicted grades for subjects I have not yet taken GCSE Subject Predicted Grade GCSE Subject English Language Law Mathematics Music Art PE Biology Physics Business Studies RE Chemistry Resistant Materials Citizenship Science Design Technology Sociology Drama Spanish Electronics Statistics Engineering Textiles English Literature Food Technology BTEC Subject French Media Studies Geography Science German Sports Studies Graphic Products Health & Social Care Other History ICT Predicted Grade Actual grades for subjects I have already achieved Continued on next page 2

3 The Two Year Programme: Level 3 Subject Choices for September 2019 PLEASE CHECK THE ENTRY CRITERIA CAREFULLY BEFORE MAKING YOUR SELECTION PLEASE INDICATE YOUR 6 CHOICES BELOW IN ORDER OF PREFERENCE You must choose at least 6 subjects. You may mix A levels and Technical Level subjects Courses run subject to numbers applying All students will study The Aspirations Portfolio in Year 12 and The Extended Project Qualification in Year 13 SUBJECT: PLEASE PREF SUBJECT: TICK 1-6 A Level Technical Level 3 PLEASE TICK Art Engineering PREF 1-6 Biology Health and Social Care Business Studies Chemistry Computer Science English Literature Drama & Theatre Studies French Further Mathematics History Geography Law Linguistics Mathematics Media PE Philosophy & Ethics Photography Physics Psychology Sociology Spanish Textiles 3

4 Statement in support of Application: To be completed by ALL applicants: In the space below, please explain why you would like to study at Banbury Aspirations Campus. Please provide any additional information which may be relevant to supporting your application for sixth form: (membership of clubs/ teams/duke of Edinburgh/Sporting Achievements/Music Achievements /work experience/volunteer or charity work etc.) 4

5 Student declaration I certify that all the information given is correct. Signed: Date: Parent / Carer Declaration I endorse this application. Signed: Date:... Relationship to applicant:.. Although we cannot absolutely guarantee that you will have a place on all your subject choices, meeting the deadline gives you the best possible chance. In addition, some courses may fill early and you could be put on a waiting list. Applications received after 9th March, 2019 will be treated as late and places on courses / in the Sixth Form cannot be guaranteed. Please also be aware that subject availability is dependant on subjects interest and subjects will not be run if the interest is deemed too low. End of Application Form 5