Online Application Form

Stage 1 of 8

To apply for a place at the Blackpool Sixth Form College please complete this form.
Please provide an email to allow us to acknowledge your application.

Please note mandatory fields are marked with an *

Personal Details

If you have previously started an application please log back in as a returning user to complete it or if you are unable to login please contact Blackpool Sixth. If you have previously submitted an application please contact Blackpool Sixth to make any changes by emailing appchanges@blackpoolsixth.ac.uk

Legal Surname *

Previous Surname
(Surnames known by in the last three years)

Legal First Name(s) *

Chosen First Name *

DOB*

Home Phone Number

Mobile Number

Current School/College *

If not in list, please state

Not currently at School?

Last School attended *

If you are not coming from school please state what you are currently doing *

Email Address *

Confirm Email Address *

This email address has already been used.
If you have previously started an application please log back in as a returning user to complete it or if you are unable to login please contact Blackpool Sixth. If you have previously submitted an application please contact Blackpool Sixth to make any changes by emailing appchanges@blackpoolsixth.ac.uk

Email addresses do not match, please check and try again.

Password *

Please provide an email to allow us to acknowledge your application

Personal Details (Continued)

Address *

Town / City *

County *

Country *

Post / Zip Code *

How many years and months have you have lived at this address? Years Months

Previous Postcode (if you have lived at the above address less than 3 years)

Legal Gender *

Chosen Gender Identity *

Birth Country *

Nationality * UK
EU/EEA
Other

If not UK, please state

UK Resident (Over 3 years) * Yes
No

Resident in the EEA/EU 3 or more years * Yes
No

Doctors Surgery

Have you previously enrolled at Blackpool Sixth? * Yes
No

School Details Primary School *

Parent / Carer / Guardian Contact Information

You can provide contact information for up to two people to whom you would like correspondence to be sent.
These people will receive information from receipt of your application and updates about your pogress whilst at sixth form.
Please include the area dialling code or telephone numbers and any extensions.

Primary Contact *

Title *

Forename *

Surname *

Same Address as Applicant

Address *

Town / City *

County *

Country *

Post / Zip Code *

Home Phone Number

Mobile Number

Email Address

Parent / Carer / Guardian Contact Information

If appropriate fill in secondary contact information.
Please include the area dialling code for telephone numbers and any extensions.

Secondary Contact * Parent
Carer
Guardian
Other
Not Applicable

Title *

Forename *

Surname *

Same Address as Applicant

Address *

Town / City *

County *

Country *

Post / Zip Code *

Home Phone Number

Mobile Number

Email Address

Emergency Contact Information

Please include the area dialing code for telephone numbers and any extensions

Name

Relationship (e.g. Grandmother)

Telephone Number

Where is this number for?

Qualifications predicted 2017

List all you are entered for this year and any already obtained.

Course Type & Level	Subject(s)	Predicted Grade for 2017 if applicable	Grade if already obtained	Year if obtained

Courses Applied For

You will be required to take GCSE English Language and Maths if you do not obtain a minimum grade 4. This will be discusses at your interview.

Course Type & Level	Subject Choices

Equal Opportunities Monitoring

Please choose from the box below the one which you feel most closesly describes your ethnic origin: *

Please tick if you speak English as a Second Language

Career Ideas

Please indicate your current intentions after sixth form Higher Education (e.g University)
Employment

Future career/study area if known (e.g business, engineering)

Interests / Activities Briefly outline any interests or roles of responsibility you have e.g head boy/girl, volunteering
(max. 200 characters)

Additional Information

Did you attend an open event? *

Yes No

How did you hear about the open event?

Do you have any criminal convictions, cautions, reprimands or final warnings? *

Yes No

Do you have any prosecutions pending, bail conditions or involvement with the youth offending team? *

Yes No

Have you ever been the victim of bullying or harassment that may be relevant to college? *

Yes No

If you select 'Yes' for any of the above we will contact you for further details.

Additional Support*

We are committed to meeting the needs of all of our students, so please contact Additional Support to inform the college about the support or exam arrangements you have received in High School: learning.alert@blackpoolsixth.ac.uk

The information you provide will not affect your chance of being offered a place at college.

You can decide who is informed about your needs when you sign the Disclosure Agreement during the enrolment process.

I have a medical condition, learning difficulty or disability
e.g. Dyslexia, Dyspraxia, Autism Spectrum, ME, Mental Health issues, sensory needs or other.

Please provide details:

I have exam arrangements at school e.g. laptop, extra time, scribe, etc.

Please provide details:

I have special dietary requirements or food allergy.

Please provide details:

I am living or have lived in care/residential care accomodation

I live independently

I am a young carer

None of above apply

Privacy Statement 2016/17

How We Use Your Personal Information

The personal information you provide is passed to the Skills Funding Agency, and the Department for Business, Innovation and Skills (BIS).

Where necessary it is also shared with the Department for Education, including the Education Funding Agency.

The information is used for the exercise of functions of these government departments and to meet statutory responsibilities, including under the Apprenticeships, Skills, Children and Learning Act 2009, and to create and maintain a unique learner number (ULN) and a Personal Learning Record (PLR). The information you provide may be shared with other organisations for education, training, employment and well-being related purposes, including for research.

We may also receive and exchange data with your former Secondary School for reasons relating to education and well-being.

Further information about use of and access to your personal data, and details of organisations with whom we regularly share data are available at: https://www.gov.uk/government/publications/sfa-privacy-notice.

I agree to not book or accept holiday during term time. If there are extenuating circumstances then I will seek permission from the Principal, in writing, at least one month in advance of booking/arranging the holiday.

I understand that taking an unauthorised holiday during term time will result in suspension and may result in permanent exclusion. I will share this information with my parent/guardian/carer.

I have filled in the data on this form and certify that it is correct to the best of my knowledge. I confirm that I have received appropriate advice and guidance to assist me in identifying the study programme which best suits my needs and abilities.

I have filled in the data in this form and certify that it is correct to the best of my knowledge.

Returning User?

If you have already started your application please login here with
your email and password.

Important Message
If you are leaving this form to continue your application in the future you MUST click save and log out. If you close the browser without this step your personal information may be visible to other users.