sixth form
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Application Form

Please fill in this form if you wish to apply to enter the Wellsway Sixth Form.

General information

Year of Entry: *
Name: *
Date of Birth: / / *
Sex: Male Female
Address: *
Home Telephone number: *
Student Mobile Telephone number:
Parental Mobile Telephone number:
Student Email: *
Internet address of
passport-size photograph:

If you cannot provide the internet address of a suitable photograph, we would be grateful if you could send us one by post.

* These fields are mandatory.

Current School or Schools attended since the age of 11

Name of School(s):

Please include dates attended if you have attended more than one.
Tutor group:

Learning

Subjects studied to GCSE and equivalent

Name of Subjects and predicted grades:

Enrichment

General Interests and Hobbies:

Progession

Future Career or Higher Education aspirations:
(if known)

The Sixth Form Curriculum

AS/A Levels

You will see in the Prospectus details of the courses we expect to offer. After consultation and advice please write down the 4 A Levels or equivalent you wish to study in the box below.

If you are unsure that you will gain five or more A*-C grades at GCSE but are still interested in joining Wellsway Sixth Form Centre, please contact Mrs Densley.

1: Level:
2: Level:
3: Level:
4: Level:

Additional Subjects

Please indicate below if you wish to study one of the additional courses we offer:

Extended Project Sports Leadership Award GCSE Maths retake GCSE English retake None

Pastoral and Academic Support

Is there any particular way that we, as a Sixth Form, can support your learning?
(S.E.N. – extra time/support, family circumstances, personal concerns).

Student Comment

If ther eis any further information you would like to provide, any points you would like to raise or any question you would like to ask, please indicate below.

We recommend you keep a copy of this form.  If you have a printer available, we suggest you take this opportunity to print a copy now.
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