Application Form

Personal Details

Welcome to Copleston Sixth Form application page. If you would like to talk to someone about our Sixth Form or your application, please email Mr Leach on dleach@copleston.suffolk.sch.uk

PERSONAL DETAILS

Student Details

First Name* Surname* Date of Birth (dd/mm/yyyy)* Address Line 1* Address Line 2 (Optional) City* Postcode* Telephone Number* Email Address*

Parent/Guardian Details

Title* First Name* Surname* Parent/Carer Phone Number* Parent/Carer Email*

NEW APPLICANTS TO COPLESTON SIXTH FORM ONLY

Current School* Address Head of Year 11

Your Courses

Courses applied for: (A Level Courses are Level 3)

	Subject	Level
1
2
3
4

COPLESTON SPORTS ACADEMY

Please tick the appropriate box if you are interested in joining one of our sporting excellence programmes.Basketball AcademyDance Academy

Your Qualifications

Please rate the following

	Please state all of your current subjects	Estimated EOC grade (available from last report )	Examination grade (if already taken)

About You

ADDITIONAL INFORMATION

All applications are subject to a satisfactory reference. We will contact your current school for information regarding your academic progress and suitability for the courses for which you have applied. By signing your application form, you are giving Copleston Sixth Form permission to ask for and receive this Information.

It would be useful if you could provide us with details of any medical or educational issues
i.e. EHCP, Exam access arrangements, EAL, etc which we should be aware of in order to meet your needs in Sixth Form.


Physical disability or medical needs:
Particular learning needs or difficulties: ( including EAL – which language)
Exam access arrangements: (i.e. extra time, reader,etc)

Do you have an EHCP?*YesNo

Do you have school based support?*YesNo

Please tell us about your interests and activities outside of lessons/school: Other Applications: where else, if anywhere, are you intending to apply (include all education, training or employment applications)

Complete Application

Agreement*I understand that the combination of subjects I have chosen may not be possible owing to staffing and timetable constraints. I will be given the opportunity to discuss any clash or query once the option columns have been finalisedI understand that if I join Copleston Sixth Form, I will be committed to working hard and being a responsible member of the school community.I agree to inform Copleston High School as soon as possible if I decide not to take up a place offered.