Huish Sixth Application

Sixth Form Application
Student Information
Name*

First Name Middle Name Last Name
Preferred Name
Nationality*
Country of Birth*
First Language*
Ethnicity*
Date of Birth*

DayMonth Year
Date
Address*

Street Address

Street Address Line 2

Town/City County

Post Code Country
Are you an existing Huish Episcopi Academy pupil?*
Which school did you attend previously?*
Mobile Number
Gender*
Email*
example@example.com
Parent/Carer Information
Parent/Carer 1 Name*

Prefix First Name Last Name
Copy student address
Parent/Carer 1 Address*

Street Address

Street Address Line 2

Town/City County

Post Code Country
Parent/Carer 1 Home Telephone*
Parent/Carer 1 Mobile*
Parent/Carer 1 Work Telephone
Parent/Carer 1 Email*
example@example.com
Parent/Carer 1 relationship to Candidate*
Parent/Carer/Emergency Contact 2 Name*

Prefix First Name Last Name
Copy student address
Parent/Carer/Emergency Contact 2 Address*

Street Address

Street Address Line 2

Town/City County

Post Code Country
Parent/Carer/Emergency Contact 2 Home Telephone*
Parent/Carer/Emergency Contact 2 Mobile*
Parent/Carer/Emergency Contact 2 Work Telephone
Parent/Carer/Emergency Contact 2 Email*
example@example.com
Parent/Carer/Emergency Contact 2 relationship to Candidate*
To Whom should correspondence be sent?*
Did you use a laptop during your exams, have extra time, or any other special need?*

YesNo
Please specify*
Do you have an Educational Health Care Plan (EHCP)?*

YesNo
Subjects currently being studied
Reasons for Huish Sixth application

Please write a brief paragraph explaining why you are applying to Huish Sixth Form and what you hope to achieve in the two years with us.
Why are you applying to Huish Sixth?*
Please tick to be considered for the Huish Sixth gateway curriculum

I wish to be considered for the Huish Sixth gateway curriculum
Provisional A level subject choices

Most students will study 3 A Levels next year but some will study 4. Please choose the most likely subjects to be studied next year.
Preference 1*
Preference 2*
Preference 3*
Preference 4/EPQ (optional)
If there are other subjects being considered at the moment – please select the alternative subject possibilities below.
Alternative Subject 1
Alternative Subject 2
Should be Empty:

Sixth Form Application

Student Information

Parent/Carer Information

Subjects currently being studied

Reasons for Huish Sixth application

Provisional A level subject choices