TEST PAGE

Student Information
First Name*
Last Name*
Date of Birth*
Gender*
- Male
- Female
Current Address*
House Number and Street Name Town Postcode
Home Telephone Number*
Student Mobile Number*
Student's Personal Email Address*
Enter Email Confirm Email
Student Education
Current School*
Current School (Other)*
If you have already achieved any GCSE/Level 2 qualifications, please use the box below to list them. Please use the following format in the box: Maths - B, English - A, Geography - A
GCSE/Level 2 Already Achieved
Subject Choice 1*
Subject Choice 2*
Subject Choice 3*
Subject Choice 4
Intended Career
Educational Support

If You Have Ever Had A Statement Of Special Educational Needs Or Been On The SEN Register At School Action Plus Or School Action, Please Advise On The Type Of Difficulty Below: SPLD, MLD, BESD, SLCN, ASD, HI, VI, PD. If Any Other, Please Specify:
SEN Support
If you have any additional support requirements, either medical or learning, please let us know here:
Additional Support
Are you happy for the Academy to communicate with you using your email address and via text messages to your mobile phone?*
- Yes
- No
Declaration*
- I declare that I am the named person listed on the form and the information I have provided is truthful and correct.

Student Information