ib application form
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8/8/2019 IB Application Form
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S I X T H F O R M
IB APPLICATION FORM
THE ARTHUR TERRY SCHOOL
SEPTEMBER 2011
Kittoe Road, Sutton Coldfield, West Midlands, B74 4RZ Tel: (0121) 323 2221 Fax: (0121) 308 8033
School Email: enquiry@arthurterry.bham.sch.uk Admissions Email: agambles@arthurterry.bham.sch.uk
Website: www.arthurterry.bham.sch.uk
Headteacher: Christopher Stone, BEd (Hons), M.A.
Assistant Headteacher & Director of Sixth Form StudiesNeil Bowater, BSc (Hons), PGCE
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APPLICATION FOR A COURSE STARTING IN SEPTEMBER 2011Please complete all of the sections using BLOCK CAPITAL LETTERS
Parental/Guardian consent is required if the applicant is under 18 years of age
STUDENT DETAILS
Surname / Family Name: First Name/s:
Date of Birth:
Gender:
Email Address:
House Number / Name:
Street:
Town:
Postcode:
CONTACT DETAILS - 1stName:
Relationship:
Address if different from above
House Number / Name:
Street:
Town
Postcode:
Home Phone Number:
Work Phone Number:
Email Address:
CONTACT DETAILS - 2ndName:
Relationship:
Address if different from above
House Number / Name:
Street:
Town
Postcode:
Home Phone Number:
Work Phone Number:
Email Address:
Mr: Mr:
Schools hold information on students in order to run the education system. The information collected will be processed in compliance
with the above named Act.
It will be used to administer your child’s progress through the education system and may be shared with DCSF, Local Authority, other
schools and educational establishments to which our child may progress, future and prospective employers, health and welfare
practitioners and Connexions. (Please refer to our policies and procedures regarding Data Protection on our school website).
Connexions are entitled by law to receive details of students’ and parents’ names and addresses, but often find additional information
beneficial when dealing with students.
If you do not wish additional data to be disclosed to Connexions, please tick the box otherwise we will assume we have our consent to disclose additional relevant information.
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MEDICAL DETAILS
Details of Special Educational Needs / Medical Conditions:Doctor’s Name:
Address:
Phone Number:
Parent/Carer Disability Information Student Disability Information
Do you and/or student have a diagnosed disability?(This includes any medical, learning or physical disability that affects your day to day life)
If so please give details here. Send separate letter if confidential to: The Office Manager, The Arthur Terry School, Kittoe Road, Four Oaks, Sutton Coldfield, B74 4RZ
Choose your options on the table below - remember you have to choose a subject from Group 1, 2 and 5. You also need to ensure that you have chosen three Higher Level (HL) subjects and three Standard Level (SL) subjects.
Remember you can choose 2 sciences from Group 4 instead of a Group 6 subject if required.
Group 1 HL SL
English
Group 2 HL SL
French
GermanSpanish
Group 3 HL SL
Business &
Management
Psychology
Geography
Group 4 HL SL
Biology
ComputerScience
Physics
Group 6 HL SL
Chemistry
VIsual Arts
Music
Theatre
Group 5 HL SL
Mathematics
Your subject choices are not binding at this stage and will be used to plan the IB curriculum for all interested candidates.We cannot guarantee that all subjects will be available for study, any comments / concerns will be
discussed at interview.
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About yourself. We would like to know as much as possible about you, your interests and other activities. Use this space to tell usabout yourself. Include details of any jobs, training schemes or work experience you have done. Indicate what activities you wouldlike to continue with in the Sixth Form, e.g. Music, Drama, Sports etc.
PUBLIC EXAMINATIONS
What are your future career intentions? (You may not know at this stage)
What school do you currently attend? Date you started at your current school:
Reference. Please give the name, status and address of asuitable referee (someone who knows you personally and canwrite about you). This should be your Achievement Co-ordinatoror Head of Year.
Referee’s Name:
Address:
Phone Number:
TYPE OF EXAMGCSE, BTEC
SUBJECTTARGETGRADE
MOCK GRADE(IF APPLICABLE)
ACTUALGRADE
YEAR OF AWARD
Student Signature. I undertake to honour in full the requirements of my
agreed study programme and school Sixth Form Regulations.
Signed _________________________________________________________
Parent / Carer Signature. I support this application and agree to the
terms of acceptance (in signing this form you are also confirming that
your son/daughter will be living with you throughout their time at the
Arthur Terry School Sixth Form. If this is no the case or circumstanceschange please contact the school).
Signed _________________________________________________________
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