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)

Sex at birth*

Is your gender identity the same as your sex at birth? *

There may be some circumstances where the sixth form will need to use your
legal name and sex at birth, such as for some examination bodies/certificates.

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 2019

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

Course Type & Level	Subject(s)	Predicted Grade for 2019 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 discussed at your interview.
Please select the A level course type option for the Level 3 Certificate in Financial Studies and the BTEC course type option for the Cambridge Technicals Level 3 in Engineering.

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?

Have you attended an event at Blackpool Sixth prior to Year 11?

Yes No

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 us about the support or exam arrangements you have received in secondary school: learning.alert@blackpoolsixth.ac.uk

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

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 2018/19

The data which you provide in this application form is held in compliance with the data protection legislation. The college collects information about all applicants for admissions, marketing and health and safety reasons.

Data may be shared with other educational and welfare organisations (e.g. schools and local authorities) and other partner organisations for the legitimate purposes of providing the best possible learning experience and environment for the individual. Your rights to access and amend your data are protected by the current data protection legislation. If you require further information please the college Privacy Statement on the website or alternatively you can contact the college’s Data Protection Officer by emailing dpa@blackpoolsixth.ac.uk

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 understand that I will need to provide proof of identity at enrolment in the form of either a current passport or the long version of my birth certificate.

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.