FOR OFFICE USE ONLY
Rec
Int
Dec
A
Q
R
APPLICATION FORM
Head of Sixth Form
Surname ______________________
Mr G R Evans
Tutor Group ________
Date __________
Full Legal Forename ___________________ Middle Name(s) _________________________
Date of Birth ____/____/____ Unique Candidate Identifier (UCI)
(for external candidates only – see your Examinations Officer)
Home Address
____________________________________________________________________________
_________________ Post Code ____________
Telephone Number ___________________
Parental e-mail ___________________________ Parental mobile ______________________
Please give names, addresses (if address different from above) and daytime contact numbers
for all adults with parental responsibility:
1.
2.
GCSE COURSES IN YEAR 11
Please list all GCSE/ Level 2 courses you are taking in the grid below.
Subject
Full/Short
Target
Grade
Subject
1.
7.
2.
8.
3.
9.
4.
10.
5.
11.
6.
12.
Full/Short
Target
Grade
DETAILS OF ANY OTHER ACTIVITIES OR COURSES (EG YOUNG ENTERPRISE, KEY SKILLS,
DUKE OF EDINBURGH AWARD, MUSIC EXAMS)
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SIXTH FORM ENTRY REQUIREMENTS
You will need a minimum of 5 grade Cs at GCSE, or equivalent, from at least 4 different
subjects. You must also have at least one of GCSE English Language or GCSE Maths at C
grade or above. Usually you will require at least a B grade in your chosen subjects. (See the
Prospectus for individual course requirements)
The normal course load is four subjects at AS dropping to three in Year 13. Health and Social
Care can be taken as a Double or a Single Award. A Double Award is the equivalent of two
courses and therefore has twice the timetable allocation and is chosen as two of the four
courses.
HOW TO APPLY
1. Read the Sixth Form Prospectus carefully.
2. Talk to your teachers about the courses, your suitability for them and ensure each teacher
completes a recommendation code in the subject choices table, on the next page.
3. Apply to enter Devizes Sixth Form by filling in this application form and sending it together
with the signed Sixth Form Standards Document to:
Mr G R Evans
Head of Sixth Form
Devizes School
The Green
Devizes
Wiltshire
SN10 3AG
Deadline for receipt of applications is
Friday 22nd January 2016
MAKING YOUR CHOICES
Careful choices at this stage will help reduce the likelihood of having to change courses in the
future. Consult both the prospectus and your teachers regarding the course offer below.
Course offer for September 2016
Art & Design
Film Studies
Physics
Applied Performing Arts
French
Psychology
Applied Science BTEC
Further Mathematics
Religious Studies
Biology
Geography
PE
Business Studies BTEC
Health and Social Care (Single
Award)
Sport L3 Cambridge Technical
(Single)
Health and Social Care (Double
Award)
Spanish
Chemistry
DT: Graphics
DT: Resistant Materials
Drama & Theatre Studies
English Language
History
ICT BTEC
Mathematics
English Literature
An individual course may not operate if option numbers indicate insufficient demand.
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From the course options list enter your choices below, choosing four courses in order of
preference 1-4. Then, where appropriate, get your current teaching staff to complete the
recommendation boxes below.
No
STAFF recommendation and
initials* See box below
Subject
1
2
3
4
Exceptionally there may be students who wish to take 5 subjects at AS.
5
*Recommendation Codes for TEACHING
1.
2.
3.
4.
STAFF to use when filling in box above.
Student is very conscientious and will achieve at least a grade B at GCSE and is therefore highly
recommended for the course
This student is hard working and their likely GCSE grade is appropriate for this course.
This student has the ability to achieve a grade at AS level but has yet to show the level of commitment or
reliability necessary to go on to achieve at A2 level.
The student is not recommended for this course because of their current level of achievement, level of
attendance and/or unreliability in meeting deadlines.
Tutor comment: (Confidential matters should be forwarded to Mr Evans separately)
(Your tutor should be asked to complete this box for you)
Please use the space below to outline any career path or Higher Education plans you have
considered.
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________
EXTERNAL CANDIDATES PLEASE NOTE ADDITIONAL SECTION OVERLEAF
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SECTIONS BELOW ARE FOR EXTERNAL CANDIDATES ONLY
PLEASE COMPLETE THE FOLLOWING
REFERENCE
Please give the name and school address of your Head of Year from whom a reference will be
requested.
Name: ..........................................................
Position: ......................................................
Address: .....................................................................................................................…
We are required to provide data, including statistical analysis of the ethnicity of our students, to
Wiltshire County Council. Please tick below to indicate which group most closely reflects your
background. This information does not form part of the application procedure.
White British
Black-African
Black-Caribbean
Black-Other
Bangladeshi
Indian
Pakistani
Chinese
Other (please specify)
First Language …………………………………………
Home Language ……………………………………..
Religion ………………………………………………...
……….…………………………….
MEDICAL
Medical Practice ……………………………………………………….
Address …………………………………………………………………
Does you have any medical conditions and/or other information of which the School should be
aware? If ‘Yes’, please give details on a separate sheet.
ACCESS ARRANGEMENTS
Do you, or have you ever had, any special access arrangements for external exams, such as a
reader, a scribe or extra time to complete your exams?
YES/NO
If yes please detail those arrangements here
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PLEASE NOTE THAT INCOMPLETE APPLICATIONS WILL BE RETURNED
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