For Office Use Only
Date received:
Application Number:
Input on J Drive:
Brackley Road, Towcester
Northants, NN12 6DJ
Telephone:
Facsimile:
e-mail:
website:
01327 350284
01327 359061
jfreer@sponne.org.uk
www.sponne.org.uk
Headteacher:
Mr Iain Massey
Input on SIMS:
Sixth Form Student Application Form
To apply for a place in the Sixth Form at Sponne School, please complete this form and return to Sixth Form
Application, Sixth Form Study Area at the school address above. The deadline for ALL applications is 11th
February 2016.
Student Details:
Surname:
Forenames:
Home Address:
Postcode:
Date of Birth:
Male/Female:
Home Telephone
Number:
Student Email:
Student Mobile:
Tutor Group:
Student Unique Learner
Number:
(Internal Students only)
Parent/Carer Details:
Mr/Mrs/Miss/Ms/Dr
Name:
Relationship to student
Contact Information
Home Tel:
Mob/Work Tel:
Email Address:
Do you have any other children at Sponne school? Please give names and relevant year group:
Emergency Contact Details:
Mr/Mrs/Miss/Ms/Dr
Name:
Relationship to student:
Contact Information:
Home Tel:
Email Address:
Mob/Work Tel:
EXTERNAL APPLICANTS ONLY
Education Details: (Please give details of your current secondary school/college)
School College:
Full Address:
Attended From:
To:
Head of Year Name:
Email Address:
* ULN Number:
*UCI Number:
(Unique Learner Number)
*UPN Number:
(Unique Candidate Identifier)**
**Available from your Exams Office
*Must be completed by all external applicants
(Unique Pupil Number)
EXTERNAL APPLICANTS ONLY
Referee Details: (Please provide the name of a suitable referee who may be asked to comment on your application).
Applicants still at school should provide the name of an appropriate member of school staff as referee
Name:
Full Address:
Position:
Email address:
Supporting Statement: (all students to complete where posssible)
Please attach to your application a supporting personal statement writing a few words about your hobbies,
interests, community responsibilities, your career experience to date, sports or leisure activities.
Do you have any difficulties that may require special facilities in order to meet your study needs e.g. health
problems, learning support for dyslexia/any other disabilities/difficulties?
Please tick the appropriate box: Yes
No
If YES please give details.
Have you had a learning mentor?
Please tick the appropriate box: Yes
No
If YES please give details.
When completed please ensure that your parents/guardian sign and date below and you return this form to
the appropriate box in the Sixth Form Study Area. External applicants please forward to Sponne School
address at the top of page one.
Student Declaration:
I agree to comply with the general rules and regulations and with any particular conditions of acceptance. I certify
that all the information given is correct.
Student signature:
Dated:
………………………………………………………………………………………. ……….…………………………………..
As you are under 18 years of age please ask a Parent/Carer to sign and date this application.
I endorse this application:
Dated:
Signed: ……………………………………………………………………………
Relationship to applicant::
…………………………………………..
My Qualifications:
GCSEs, BTEC First Diplomas and other qualifications.
Please tick the subjects you are taking and indicate your predicted grade, if known. Possible predicted grade
values are A*, A, B, C, D, E, F and G for GCSE and BTEC First Diplomas they are Distinction (D), Merit (M),
Pass (P) and Fail (F). If you have already completed an exam, write the grade and put ‘actual’ next to it.
Add other subject if not listed
SUBJECT
GCSE
BTEC
OTHER
(please specify)
PREDICTED
GRADE
Art
Childcare
Citizenship
Dance
Drama
Business Studies
Electronics
Engineering
English Literature
English Language
Food Technology
French
Geography
German
Graphic Products
Health & Social Care
History
ICT (Creative i-media)
ICT (Nationals)
Law
Maths
Media
Music
PE
Philosophy & Ethics
Product Design and Technology
RE
Resistant Materials
Science (Core)
Science (Cambridge Nationals/BTEC)
Science (Additional)
Science (Additional Applied)
Science (Biology)
Science (Chemistry)
Science (Physics)
Sociology
Spanish
Sports Studies
Statistics
Textiles
OTHER SUBJECT
EXAM BOARD
PREDICATED
GRADE
My Choices:
Please check the entry criteria carefully before you make your selection - please fill in your choices :
Entry requirements: 6 GCSE A* - C grades including English or Maths with at least one B grade in any
subject.
All Routes - Please choose 3 subjects from the blocks below. REMEMBER: Only ONE subject per block.
Option
Block
A
B
C
D
E
Subject
Subject Entry Minimum Requirement
Biology
Economics
French
Geography
Media
Philosophy
Drama & Theatre Studies
Art (Fine)
Chemistry
ICT Animation & Graphic Design
ICT Web Applications
Mathematics – A Level
Product Design
Psychology
BTEC Business (Extended
Certificate)
Business
Food
Further Maths
History
Music
Photography
English Language & Literature
Health & Social Care
History
ICT Computing
Mathematics – A Level
Mathematics - Core
English (re-take)
Maths (re-take)
Applied Science
Applied Travel & Tourism
English Literature
Geography
German
PE
Physics
Grade B in Biology or two B grades in Core and Additional Science
Grade B in English and Maths
Grade B in French (in higher listening and reading papers)
Grade C in Geography
Grade C in English and Media GCSE (if taken)
Grade C in RE
Grade C in English and Grade C in Drama GCSE (if taken)
Grade C in Art
Grade B in Chemistry or two B grades in Core and Additional science
Grade C or above in 6 subjects
Grade C or above in 6 subjects
Grade A in Maths
Grade C in Design & Technology
Grade C in English and Science and Grade B in Maths
Grade C in English and Maths
Sociology
Grade C in English, Maths and Science
Subject
clashes:
Grade C in English and grade B in Maths
Grade C in Design & Technology
Grade A* or high A in Maths with a teacher recommendation
Grade B in History
Grade C in GCSE Music and/or minimum grade 5 instrumentalist/vocalist
Grade C in Art
Grade C in English Language and Grade B in English Literature
Grade C in English and Maths
Grade B in History
Grade B in Maths
Grade A in Maths
Grade C in Maths (Foundation or Higher Level)
Grade D in English
Grade D in Maths
Grade C in English
Grade C in English
Grade C in English and grade B in English Literature
Grade C in Geography
Grade B in German (in higher listening and reading papers)
Grade C in English and Grade B in Core and Additional Sciences
Grade B in Physics and Maths or two grades in Core and Additional Science
and a grade B in Maths
Please clearly show all subject clashes by selecting both subjects in the option blocks above and make any
additional comments here: