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Heathside School Application Form for External Applicants for Admission to Year 12 for Entry in September 2022

Closing Date for Applications: Monday 6th December 2021

Please provide information requested using this online application form. The personal data you provide will be used to assess and process this application to the Sixth Form and for the purposes of curriculum management.

Under data protection law, individuals have a right to be informed about how Heathside School collects, stores and uses personal data. Heathside School uses and processes personal data in accordance with the Data Protection Act 2018 (DPA 2018). For further information, please download our Privacy Notice below.

Privacy Notice for Students, Parents and Carers Download

Section 1 - Student Details

Please complete all questions below with details of the student applying for a Sixth Form place.

Student's Legal Surname *

Student's Legal First Name *

Gender: *

Male

Female

Date of Birth - Please contact Mrs Best if your Date of Birth is not between 01/09/2005-31/08/2006 *

Student's Home Address

House Name:

House Number: (Number)

Street/Road Name: *

Second Line of Address:

Post Town: *

County: *

Postcode: *

Section 2 - Parent/Guardian Contact Details

Please complete name and contact details below for the parent/guardian submitting this form.

Parent/Guardian First Name: *

Parent/Guardian Surname *

Parent/Guardian Home Telephone Number: (Number)

Parent/Guardian Mobile Phone Number: *

Parent/Guardian Email Address: *

Please confirm the Parent/Guardian Email Address: *

Section 3 - Academic Choices

Please indicate below the 3 A Level subjects you are considering. Please note you are not bound to these choices but require them to assist timetable planning to ensure we can accommodate your preferred options.

If you are choosing Maths and Further Maths you may decide to take 4 A Levels.

Section 4 - Details of Education

Please complete details below for your current or previous school if not currently attending a school:

Name of current/previous school *

Postal Address of current/previous school including postcode: *

Name of the Head of Year (this person will be contacted for a reference) *

School Email Address for the Head of Year: *

UCI Number:

Please list below your predicted grades in all Subjects

Subject	Examination Level e.g. GCSE	Predicted Grade

Section 5 - Declaration and Signature

Please download and and read the Admissions Policy using the link below which sets out the Admission Requirements that must be met when applying for a place.

Sixth Form Admissions Policy for Entry in September 2022 Download

I declare as Parent/Guardian, that the above named student has the right of abode in the United Kingdom: *

Yes

I confirm I have read and understood the Admission requirements outlined in the Admissions Policy and confirm the above information is correct.

Type your name and sign below

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