Sixth Form‎ > ‎

Application Form

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Information About you

 

Name

First

 

 

  

Last

 

 

Address

Street Address

 

Address Line 2

City

 

County

 

Postcode

 

Country

 

                           

Email Address

 

 

Telephone

Home No.

 

Mobile No.

 

 

Current School

Dates

School/College

 

 

 

 

 

Date of Birth

 

 

Male

 

Female

 

 

Exams to be taken / Predicted Grades

Year

Qualification

Subject

Grade

If already obtained grade please tick result here

 

GCSE

Mathematics

 

 

 

GCSE

English Language

 

 

 

GCSE

English Literature

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Future aspirations

If known

 

 

 

 

Why are you applying to NTA6?

 

 

 

 

 

 

 

 

Interests and hobbies

If known

 

 

 

 

 

Subjects you are interested in

Please select 3 or 4 courses

Art & Design

 

English Literature

 

IT

 

Applied Law

 

Forensic & Criminal Investigation

 

Law

 

Applied Science

 

Mathematics

 

Biology

 

Further Mathematics

 

Physics

 

Business

 

Psychology

 

Chemistry

 

Geography

 

Sport

 

Creative & Digital Media Production

 

History

 

 

 

 

Please select from the list below if you are interested in studying a home language in additional to you sixth form studies.

Turkish

 

Spanish

 

French

 

Polish

 

Portuguese

 

Greek

 

Dutch

 

Other please specify

 

 

Reference

Please provide the contact details of a referee who can comment on your academic achievement and attitude


Name



 

Role

 

                           

Email Address

 

 

Telephone

 

 

Declaration

If offered a place at NTA6, I agree follow the NTA6 code of contact.

 

Signature

 

Date

 

 

If you have any further questions please email NTA6@nightingaleacademy.org or speak with Ms Swift or Miss Hunt.