SIMON BALLE SCHOOL SIXTH FORM APPLICATION FOR SEPTEMBER 2011 ENTRY Please complete all sections of this form and return to Mrs Lynn Salt by Wednesday 1 st December NAME________________________________________________________________________FORM______________ ADDRESS______________________________________ DATE OF BIRTH________________M/F________________ _______________________________________________HOME No._________________________________________ _______________________________________________MOBILE No._______________________________________ _______________________________________________DAYTIME No.______________________________________ NAME OF PARENT/S______________________________________________________________________________ PARENT/S DAYTIME CONTACT NUMBER_____________________________________________________________
FOR EXTERNAL APPLICANTS:NAME OF CURRENT SCHOOL___________________________________________T/N__________________________
GCSE SUBJECTS
OTHER QUALIFICATIONS
TARGET GRADE
RESULTS
MOCK RESULT IF KNOWN
EXAM BOARD
EXAM BOARD
PROPOSED AS LEVEL SUBJECTS 1) ____________________________________________________2)___________________________________________ 3) ____________________________________________________4)___________________________________________ WHY WOULD YOU LIKE TO JOIN SIMON BALLE SIXTH FORM? __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________ __________________________________________________________________________________________________
STUDENT SIGNATURE__________________________________PARENT SIGNATURE_________________________ IF YOU WOULD LIKE ANY FURTHER INFORMATION PLEASE VISIT OUR WEBPAGE Simon Balle School. Mangrove Road, Hertford, Herts, SG13 8AJ, 01992 410400. www.simonballe.herts.sch.uk