6th Form Application

Section 1: Your personal details

For Admissions Office Use:

App. Date

App. No.

Please complete the form in BLOCK CAPITALS and in ink. Please return completed application and reference form to: Miss Smyth, Stepney Green Sixth Form, Ben Jonson Road, London E1 4SD.
Application Form 2020-2021
Full Name: (Please enter your name as it appears on official documents)*

SurnameFirst Name(s)
Gender:*

MaleFemale
Date of Birth:*
National Insurance No:
Roll no (Stepney Green students only):
Address:*

Line 1

Line 2

CityState / Province

Post Code
UPN:
ULN:
Contact no:*
Mobile no:
E-mail address:*
Parent/Guardian/Next of kin - Name:*
Relationship:*
Contact Number:*
E-mail address:
Address if different from student:

Line 1

Line 2

CityState / Province

Post Code
Second Parent/Guardian/Next of kin - Name:
Relationship:
Contact Number:
E-mail address:
Section 2: The courses you are applying for
A Level - Select one subject from each option block (1, 2, 3 & 4)
1

EconomicsPhysicsGraphicsPhilosophy & EthicsMathematics
2

ChemistryComputingPsychologyBiologyGeographyHistory
3

BiologyMathematicsFine ArtMedia StudiesSociology
4

MathematicsEnglishSports ScienceFurther MathematicsChemistryProduct Design
5

ItalianBengaliEnglish GCSEMathematics GCSE
BTEC Level 3 Extended Diploma
Select one course

Sport1
Sport 3ICT 3Business 1
Sport 2ICT 1Business 3
ICT 2Business 2
BTEC Level 2 Diploma in Business and ICT with English and Mathematics
BusinessBusinessICT
English GCSEMathematics GCSE
Important information:

Application form submission no later than: Thursday 28th November 2019. You will find full details of all courses online.
Section 3: Additional Support
Stepney Green Sixth Form College has a range of additional support. We welcome students with disabilities and health problems. Please mark the boxes that are appropriate to you.

This will not affect your application but is to enable us to consider your additional support needs.
Disability*

No disabilityVisual impairmentHearing impairmentDisability affecting mobilityA disability or special need not listed. Please state belowOther
Health*

No health problemsEmotional/behavioral difficultiesMental health difficultyProfound complex disabilitiesAspergers syndromeMultiple disabilitiesTemporary disability after illness (e.g. post-viral) or accidentI do not wish to give this informationOther
Learning Difficulty*

No learning difficultyModerate learning difficultySevere learning difficultyDyslexiaDyscalculiaOther specific learning difficultyAutistic spectrum disorderMultiple learning difficultiesI do not wish to give this informationOther
Please help us focus sixth form support and services by answering the following questions:
Are you living in the care of social services, leaving care services or living in any type of hostel accommodation?*

YesNo
Do you receive an Education/ Health and Care Plan?

YesNo
Did you receive free school meals in 2019-20?*

YesNo
If you did receive free school meals please tell us the start and end dates:
From:
To:
Section 4: Equal Opportunities
We are commited to equal opportunities. Please tick the box which best describes your ethnicity:
Asian/Asian British

IndianPakistaniBangladeshiChineseAny other asian background
Mixed/multi ethnic group

White and Black CaribbeanWhite and Black AfricanWhite and AsianAny other mixed/multiple Ethnic background
White

English/Welsh/Scottish/ Northern Irish/BritishIrishGypsy or Irish TravellerAny other white background
Black/African/Caribbean/Black British

AfricanCaribbeanAny other Black/African/Caribbean background
Other ethnic group

ArabOther
Home language
Second language
Religion
Mode of transport to Sixth Form
Section 5: Residency
Nationality (as on passport):*
Date of arrival in UK:
Passport copy included?

YesNo
Section 6: How did you hear about Stepney Green Sixth Form
How did you hear about Stepney Green Sixth Form?

InternetWebsiteNewspapersWord of MouthBannerRadioOther
Section 7: Education
Name and address of schools/ colleges you have attended. List all secondary experience (Once you have entered your school information press save to enter another line of information.) (Stepney Green applicants do not need to complete this section)*
Section 8: Qualifications
Please list any qualifications you have or expect to obtain:
All external candidates should enclose certified copies of their certificates/qualifications with their application if exams have beeen sat

All candidates must have completed at least 8 GCSE exams
Section 9: Tell us about yourself
Tell us why you want to do this course, what skills and experience you have that may be useful when studying this course? (e.g. part-time, voluntary work, other courses you have taken). What do you plan to do when you finish this course? What are your career plans?*

0/750
Section 10: Reference Form
PLEASE NOTE: We require a reference for any applicant aged 16–18.

Download and print a Reference Form here

Please send this completed application form to Ms Belaatel. Your application may not be considered until the reference form has been completed.
Submission
I hereby agree to abide by the Learning Agreement and the provisions set out in the notes below:

• I confirm that I have completed a pre-entry process with Stepney Green Sixth Form whereby I received appropriate advice, guidance and support to help me choose my programme.

• I fully understand the entry requirements, suitability and progression opportunities

• I understand and accept that the sixth form reserves the right to close or combine one class with another

Data Protection

• I understand that if I request a letter from the sixth form confirming my status as a student my address may be in the letter.

• I declare that I understand the information I have entered is correct and I understand that this information will be used by Stepney Green Maths, Computing and Science College and Sixth Form staff for enrolment and reporting purposes and that some information requested will be stored on computer.
Name of applicant:
Date:
The Tower Trust is a company limited by guarantee, registered in England and Wales, registered number 10922680.

Registered office: c/o The Clara Grant Primary School, Knapp Road, London, E3 4BU. Stepney Green Maths & Computing College is GDPR Compliant.

Further Information is available at http://www.stepneygreen.towerhamlets.sch.uk/
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Section 1: Your personal details

Section 2: The courses you are applying for

Section 3: Additional Support

Section 4: Equal Opportunities

Section 5: Residency

Section 6: How did you hear about Stepney Green Sixth Form

Section 7: Education

Section 8: Qualifications

Section 9: Tell us about yourself

Section 10: Reference Form

Submission