CHINGFORD FOUNDATION SCHOOL Sixth Form Application Form CONTACT DETAILS Telephone: 0208 506 3871 Email: sixth-form@chingford.waltham.sch.uk Website: For Sixth Form Staff use only Received I/v date O N DNAIV Please fill in all sections below as fully as possible with black pen using BLOCK CAPITALS. STUDENT DETAILS Surname Date of Birth Forename(s) (Please underline preferred forename) Address Gender Nationality Postcode Student s Email Address Home Phone Number Student s Mobile Number PARENT / CARER CONTACT DETAILS Name(s) 1 2 Relationship Address (if different from student s) Contact Number(s) Email Address Aiming to develop students who are caring, resourceful, employable and well-qualified. 1
PRESENT OR MOST RECENT EDUCATION Name of Current School or College Address of Current School or College (including postcode) Tick box if you have already started Year 12 in another Sixth Form GCSE GRADES ALREADY OBTAINED (Please do not include individual module scores only Grades for completed GCSEs) Actual Grade Actual Grade EXPECTED GRADES TO BE TAKEN THIS YEAR (Please enter GCSE English & Maths grades first followed by all other subjects) Expected Grade English Language GCSE Expected Grade Maths GCSE English Literature GCSE SIGNATURE OF REFEREE TO CONFIRM GRADES:... 2
COURSES OF STUDY APPLIED FOR: (In Year 12 you MUST select 3 subjects.) Please indicate the subjects you wish to study. Use numbers to indicate subjects in order of preference (starting with 1, 2 etc.) If possible, include a 4 th & 5 th choice in case one of your choices is unavailable. Note: Students who wish to choose Further Maths MUST also study Maths Art Biology Business Chemistry Further Maths Media Studies Physical Education Physics Computer Science Politics Design & Technology: Product Design Psychology Drama Religious Studies Economics Spanish Electronics Sociology English Language English Literature NCFE Skills in Business Level 3 French Cambridge ICT Technical Level 3 Geography BTEC Creative Digital Media Production History BTEC Performing Arts Maths NCFE Sport Level 3 3
PERSONAL STATEMENT In the box below, please answer the following statements. Continue on to a separate A4 page if needed. 1. Why you would like to study the subjects you have indicated, and why you think that they are appropriate for you? 2. Please tell us about yourself your interests, responsibilities, participation in activities both inside and outside of school. (You may attach copies of pages from your Progress File / Record of Achievement) 3. What you intend to do in the future after Sixth Form. 4
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PERSONALISED LEARNING SUPPORT Special Educational Needs If you have any Special Educational Needs, please tick and attach information with this application form. Free School Meals If you have received Free School Meals at any time during Years 7-11, please tick. English as an Additional Language If you normally speak a language other than English at home, please write which language(s) in the box: FURTHER INFORMATION Simply to help us with planning, please circle how likely you are to join the Chingford Sixth Form Definitely Very likely Possibly DECLARATIONS PLEASE READ THE FOLLOWING STATEMENT AND SIGN BELOW I am fully supportive of the ethos of Chingford Sixth Form as described in the prospectus. I unconditionally agree to work hard and comply with Sixth Form rules & requirements. I want to be helped to achieve my best and want to be held to account for my performance and conduct. I declare that all the information given on this form is correct. Student signature Date PARENT(S)/CARER(S) I support my child s application for a place in the Sixth Form at Chingford Foundation School. Parent/Carer signature Date Care Status If the student is or has ever been in local authority care, please tick this box and supply details with this application form. 6
SCHOOL REFERENCE STUDENT REFEREE Please pass this form to the person in your school responsible for writing your reference. Thank you for completing this reference. Please feel free to attach a copy of your standard school reference & SIMS attendance printout. Please also would you sign to show your agreement with the estimated grades on page 2 of the application form, amending as necessary. KEY INFORMATION Please tick the most appropriate boxes: Excellent Good Satisfactory Unsatisfactory Poor Attendance Punctuality Self Discipline Motivation to study Relationships with adults Relationships with peers Behaviour Has this pupil had any unauthorised absence? (If yes, please give details in the YES NO box below) Is this a Pupil Premium student? YES NO Do you think the subject choices are appropriate for the student s ability? (If no, YES NO please give details below) Further details: 7
ADDITIONAL REFEREE COMMENTS Please feel free to write any further information about the applicant. DECLARATION Name of Referee Position School / College Signature Date Please tick to confirm that you have checked and signed the student s estimated grades on page 2. 8
This Application Form MUST be submitted to the Sixth Form Office by the date published in the prospectus. Address for all correspondence concerning Sixth Form Admissions: Sixth Form Admissions Chingford Foundation School Nevin Drive Chingford London E4 7LT Receipt of applications will be acknowledged by email. PRIVACY NOTICE DATA PROTECTION Students have a legal right to be informed about how our school uses any personal information that we hold about them. To comply with this, we provide a privacy notice, which explains how we collect, store and use personal data. Our privacy notices can be found at /page/?title=gdpr&pid=178 9
This last page is for the use of Chingford Sixth Form Staff Choice Confirmation Other information (incl. careers aspiration, reference) 100 50 0 Interviewer Date 10