St Mary's Sixth Form College

Please complete all fields marked (*)

First Name (Legal Name) *

Last Name (Legal Name) *

Date of birth *

Preferred Name

Preferred Gender/Pronouns

E.g. She/Her

House Number/ Street Address *

E.g. 123 Cranbrook Avenue

Town/City *

Town/City

Post Code *

Country

Student Mobile Phone Number *

Parent/Carer Mobile Number *

Student School Email Address *

Personal (non-school) student email address *

Parent/Carer Email Address *

Current school *

Predicted Grades *

List your most recent GCSE mock results or predicted grades here.

Course Choice 1 (or triple award/ T Level) *

E.g. Maths/ E.g. T Level Health

Course Choice 2

Course Choice 3

Course Choice 4 - students with a high GCSE grade average may opt to study a 4th subject, although this is not necessarily advised.

What are your career plans?

Residency: If not born in the U.K., what is your country of origin?

If English is not your first language, please list main language(s) spoken.

Date of arrival into the U.K. (dd/mm/yyyy)

Reason for taking up residency in the U.K.

Not Applicable: Born in the U.K.

Work or Economic Reasons

Asylum

Refugee

Joining Family

Other

Unique Pupil Number

This number will allow us to set up your student account with us if you join in September, but do not worry if you cannot provide this yet.

Unique Learner Number

This number will allow us to set up your student account with us if you join in September, but do not worry if you cannot provide this yet.

Unique Candidate Identifer

This number will allow us to set up your student account with us if you join in September, but do not worry if you cannot provide this yet.

Do you have any Special Educational Needs?

Details of Special Educational Needs (if applicable)

Do you have an Education, Health and Care Plan?

Yes

Do you have any criminal convictions or impending prosecutions?

Yes

Details of any convictions, if applicable:

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