ib application form

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: [email protected] Admissions Email: [email protected]

Website: www.arthurterry.bham.sch.uk

Headteacher: Christopher Stone, BEd (Hons), M.A.

Assistant Headteacher & Director of Sixth Form StudiesNeil Bowater, BSc (Hons), PGCE

http://www.arthurterry.bham.sch.uk/


mailto:[email protected]











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


Street:

Town

Postcode:

Home Phone Number:

Work Phone Number:

Email Address:

CONTACT DETAILS - 2ndName:

Relationship:

Address if different from above


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.



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.



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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