Sixth Form Application Form 2020 EXTERNAL STUDENTS NEW TO ULLSWATER COMMUNITY COLLEGE Before completing this application form, please refer to the entry criteria, latest sixth form curriculum model and course information flyers on the Ullswater Community College website. Please complete this form and return it to UCC marked for the attention of Mr R Jackson (Head of Sixth Form)
1. Your Details LEGAL SURNAME:
LEGAL FORENAME:
OTHER NAME(S): PREFERRED SURNAME:
PREFERRED FORENAME:
DATE OF BIRTH:
GENDER:
NAME AND ADDRESS OF CURRENT SCHOOL:
UCI NUMBER (this will have been issued by your previous school and is your unique identifier)
STUDENT MOBILE NUMBER:
STUDENT EMAIL ADDRESS:
PARENTS/CARERS NAME:
NAME:
RELATIONSHIP TO STUDENT:
RELATIONSHIP TO STUDENT:
ADDRESS:
ADDRESS:
MOBILE NUMBER:
MOBILE NUMBER:
HOME TELEPHONE:
HOME TELEPHONE:
EMAIL ADDRESS/ES:
EMAIL ADDRESS/ES:
WITH WHOM DOES THE STUDENT NORMALLY LIVE:
2. Your Qualifications Please attach your latest school report. For information, we will need to see proof of your final GCSE grades in August.
3. Institutions being applied to Please indicate the Post 16 Providers you are applying to:
First choice
Second choice
Third choice
4. Personal Statement Please use this space to explain why you wish to be considered for a place in the sixth form at UCC:
5. Course Entry Requirements
6. Your Choices 2020/21 Curriculum plan
Making you options Please selected the three subjects that you would like to study from the curriculum plan above. Please do not pick more than one subject from each block. Please also indicate a reserve choice that you would be happy to study. If you are considering studying Childcare & Education or BTEC L3 Health and Social Care Triple, indicate this subject only in the appropriate box below. OPTION 1 OPTION 2 OPTION 3 RESERVE
Childcare and Education
BTEC L3 Health and Social Care Triple
7. Your Learning Please note if you have any medical condition, illness or any disability that might affect your studies e.g. epilepsy, diabetes, asthma
Please note if you hold an Education, Health and Care Plan, or if you have a Special Educational Need which has required additional support in the past e.g. dyslexia, speech and language difficulties etc.
Please note if you have had Access Arrangements for any external examinations and if you have English as an additional language
8. Medical Arrangements NAME OF FAMILY DOCTOR:
PRACTICE:
ADDRESS:
TELEPHONE NUMBER:
9. Travel Arrangements: The cost of transport is not funded centrally by the government. Cumbria County Council has decided to pass the cost straight on to parents. Ullswater Community College is committed to reducing this burden on family incomes and will support students where it can. Please indicate how you plan to travel to the sixth form each day:
o
School Coach
o
Public Transport Bus
o
Taxi
o
Bicycle
o
Walk
o
Private car
o
Train
10. Your Agreement This section must be signed before any offer of a place can be made. By signing below you are agreeing to the following:
I understand that if I join Ullswater Community College Sixth Form, I will be expected to adhere to the Sixth Form conventions and codes of conduct I understand that final course choices will be dependent upon my GCSE results, to be confirmed in August. If I change my choice of subjects after accepting a conditional offer I understand that I cannot be guaranteed a place in another set I agree to inform Ullswater Community College as soon as possible if I decide not to take up a place offered I agree to attend both the induction days and the results day at Ullswater Community College I understand that if I need to resit English and / or maths GCSEs, to achieve a grade 4 (or higher), that condition of my entry to the sixth form is dependent on my full attendance to taught classes and resitting of the exams I understand that, unless part of a bespoke curriculum, I am committing to a minimum of three, two year courses
Student Signature
Parent/Carer Signature
____________________________
___________________________
Date
Date
____________________________
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