BARKING ABBEY SCHOOL
6TH FORM APPLICATION FORM 2015
(please complete in BLACK INK and in BLOCK CAPITALS)
Personal Details:
Male

Female

School Details: (This must be fully completed)
School:
Surname:
Address:
First name(s):
Town:
Address:
Town:
Postcode:
Head of Year 11:
Postcode:
School Tel No:
Date of Birth:
School Fax No:
Tel No. (Home):
School email address:
Mobile No:
Email:
LIST ALL ACADEMIC SUBJECTS BEING STUDIED - WITH EXPECTED ACHIEVEMENT GRADES
Subject (CORE)
Grade
Subject (List other options) Grade
Mathematics
Science (triple OR Physics)
English Language
English Literature
Science ( core OR Biology)
Science (additional OR
Chemistry)
FUTURE CAREER (if known)
IF YOU ARE APPLYING FOR AN ACADEMY PLEASE TICK:
BASKETBALL

FOOTBALL

NETBALL

JUDO
GOLF

Handicap ………..
GIVE BRIEF DETAILS OF WHY YOU WISH TO ATTEND BARKING ABBEY SCHOOL AND WHAT YOU CAN OFFER TO OUR
SIXTH FORM
COURSE CHOICE (PLEASE COMPLETE FORM OVERLEAF)
Student signature …………………………… Parent signature ……………………… Date…………..
For Office Use
Offer of Place
Date form received …………………….
Interview
Added to spreadsheet………………….
Copy sent to Academy



Yes
Letter sent

No
Date ……………………………
Time ……………………………

Date ………………………..
OPTION BLOCKS Yr 12 2015
YOU MUST ENSURE YOU HAVE ALL THE NECESSARY QUALIFICATIONS FOR EACH SUBJECT YOU HAVE CHOSEN
(FAILURE TO DO THIS COULD JEOPARDISE YOUR PLACE AT BARKING ABBEY SCHOOL)
BLOCK A
Minimum GCSE
TICK
BLOCK B
Grades entry
BOX
requirements
L3 BTEC Diploma Sport and Exercise
5 Cs (inc PE)
L3 BTEC Diploma Business
Science
L3 BTEC Diploma Business
5 Cs (inc Eng &
L3 BTEC Diploma Sport and
Maths)
Exercise Science
Business Studies
B Eng/C Maths
L3 BTEC Extended Diploma
Science
BB
L3 BTEC Extended Diploma Dance
English Literature *
Minimum GCSE
Grades entry
requirements
5 Cs (inc Eng &
Maths)
5 Cs (inc PE)
5 Cs
5 Cs
Government & Politics
B Eng/Humanities
Art or Graphic Design
C/Merit
Maths (Pure & Stats)
High B
Business Studies
Photography
C Art or Portfolio
Chemistry*
B English/C
Maths
BB Science
Psychology
Physical Education
B Eng Language
B
BB/Science
Drama
English Literature
B Eng Language
History*
Physics *
Sociology
Further Mathematics*
Psychology
Religious Studies
Sociology
BLOCK D
BLOCK C
L3 BTEC Diploma Science
L3 BTEC Extended Diploma Business
B (+B in English)
BB
A/A* (+ Maths
Stats AS)
B (+B in English)
B Eng Language
C (B Humanities)
B Eng Language
5 Cs(inc Science)
5 Cs (inc Eng &
Maths)
5 Cs (inc PE)
L2 CSLA
L3 Certificate in Fitness
Instructing
L3 BTEC Diploma Science
5 Cs
L3 BTEC Diploma Performing Arts
Dance
5 Cs
Biology
BB Science
Biology*
BB Science
Economics
B Maths &
English
BB
B
Chemistry
BB Science
Design & Technology
Economics
B (+B in English)
C (inc Maths)
High B
English Literature
French
IT
B
B Maths &
English
BB
B
C (inc Maths)
High B
C Music
B Eng Language
Law
Maths (Pure & Stats)
Media
B Eng Language
Psychology
L3 BTEC Diploma Sport and Exercise
Science
L3 BTEC Diploma Performing Arts Dance
English Literature
Geography
History
IT
Maths (Pure & Stats)
*
Maths (Pure & Applied)
Music Technology
Psychology*
Sociology
Religious Studies*
5 Cs (inc
PE/Sport)
5 Cs (inc Science)
B Eng/Humanities
High B
B /C
English/Media
B Eng Language
C (B Humanities)
* These subjects are for all students, but should be chosen by our high performance programme cohort
NOTE FOR BTEC SUBJECTS
BTEC DIPLOMAS LEVEL 3
For Level 3 BTEC Extended Diplomas THREE blocks must be selected (equal to THREE A Levels)
For Level 3 BTEC Diplomas TWO blocks must be ticked – Science must tick Blocks (C & D), Business (A & B), Dance (C & D) and Sport (A
OR B plus any) (equal to TWO A Levels)
BTEC SUBSIDIARY DIPLOMAS – ONE BLOCK- ONLY available for Dance (Block D only) and Sports Science (Block A OR B only) Not
available for Science or Business
TICK
BOX
SIXTH FORM REFERENCE
To be completed by the Head of Year 11 or suitable alternative
NAME OF STUDENT ………………………………………………………………UPN No……………….
(block capitals)
EDUCATIONAL RECORD AT ………………………………………………………. SCHOOL
A = Excellent B = Good C = Average D = Below Average E = Poor
A
Please tick and comment below where applicable
B
C
D
E
ATTENDANCE (% if possible)
PUNCTUALITY (% if possible)
HEALTH
CONDUCT
KEENNESS AND INDUSTRY
COURTESY AND CONSIDERATION
CO-OPERATION & DEPENDABILITY
SELF MOTIVATION
ABILITY TO COMMUNICATE
COMMON SENSE
Does this student have any special educational needs? Please tick any relevant. Medical Care plan
 SEN Register  LAC  Independent Student 
Learning  Behaviour  Emotional  Physical  Speech/language  Other 
Statemented


Gifted and Talented
PLEASE GIVE GENERAL COMMENTS - Additional comments and information regarding general
abilities, positions of responsibility, special needs requirements if applicable etc.
Do you have reason to doubt student’s honesty?
Has this student ever been given a fixed term exclusion?


 No
 No
Yes
Yes
If Yes, Reason/Dates/ Number of days:
……………………………………………………………………………………………………………………………….
EXAM INFORMATION (Tick if confirming student’s grades on front page, or please complete table
Please give expected achievement grades (rather than predicted grades)
SUBJECT
LEVEL
GRADE SUBJECT
School stamp
LEVEL

GRADE
Signed ………………………………………………………
Title ………………………………………………………….
Date ……………………………………….........