Sixth Form Application - UTC Plymouth

SECTION 1: Personal details

Name

Contact phone number

Date of Birth (DD/MM/YYYY)

Age

Home address

Gender Female Male Other

Postcode

SECTION 2: Your course choice

Which course are you applying for? Engineering Engineering and A Level Maths Engineering and A Level Physics Engineering and Digital Technologies Digital Technologies Art and Design and A Level English Art and Design Pre-Apprenticeship

SECTION 3: Your previous education

List

Subject and Level (e.g. GCSE)

Year

Predicted Result

Actual Result (if applicable)

Subject and Level (e.g. GCSE)

Year

Predicted Result

Actual Result (if applicable)

Subject and Level (e.g. GCSE)

Year

Predicted Result

Actual Result (if applicable)

Subject and Level (e.g. GCSE)

Year

Predicted Result

Actual Result (if applicable)

Subject and Level (e.g. GCSE)

Year

Predicted Result

Actual Result (if applicable)

Subject and Level (e.g. GCSE)

Year

Predicted Result

Actual Result (if applicable)

Subject and Level (e.g. GCSE)

Year

Predicted Result

Actual Result (if applicable)

Subject and Level (e.g. GCSE)

Year

Predicted Result

Actual Result (if applicable)

Subject and Level (e.g. GCSE)

Year

Predicted Result

Actual Result (if applicable)

Subject and Level (e.g. GCSE)

Year

Predicted Result

Actual Result (if applicable)

Subject and Level (e.g. GCSE)

Year

Predicted Result

Actual Result (if applicable)

Subject and Level (e.g. GCSE)

Year

Predicted Result

Actual Result (if applicable)

SECTION 4: Your future plans

Please outline your reasons for wanting to attend UTC Plymouth and your career aspirations

SECTION 5: Extra support for you

We provide a range of support for learners with learning difficulties, medical and language support needs. If you would like a confidential interview, please tick here.

SECTION 6: Where did you find out about us?

Please select all that applies

SECTION 7: Emergency contact details

Emergency contact name

Relationship to you

Contact number

Contact email

Contact address

Information given on this form is personal data and is therefore subject to Data Protection Act 1998. Information you provide on this form may be passed to relevant educational agencies. Further information about data confidentiality is available on request. If you do not wish to receive such information, please select this box.

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