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LOXFORD SCHOOL OF SCIENCE AND TECHNOLOGY SIXTH FORM APPLICATION FORM 2009 (Internal Applicants) Completing this Form You must complete ALL Sections A, B, C and D SECTION A – Personal Information (Please complete in BLOCK CAPITALS and BLACK INK) Last Name: Date of Birth: ______________________________________________________________________________________ First Name(s): Male/Female: ______________________________________________________________________________________ Address: ______________________________________________________________________________________ Post Code: ______________________________________________________________________________________ Telephone Number:


______________________________________________________________________________________ E-Mail Address: ______________________________________________________________________________________ Do you consider yourself to have a disability?


If yes, please give details: ______________________________________________________________________________________

SECTION B – Academic Information Name of Current School*: Loxford School of Science and Technology _____________________________________________________________________________________ Loxford Lane Post Code: IG1 2UT ______________________________________________________________________________________ Which year group did you join Loxford? Yr 7 8 9 10 11 (please circle) ______________________________________________________________________________________ Name of Tutor: Tutor Group: ______________________________________________________________________________________ * References will be requested from your Achievement Team Leader.


SECTION B – Academic Information (continued) GCSE Subjects (Please list your GCSE subjects here and the grades you are predicted): Subject

Predicted Grade(s)

All other subjects

Predicted Grade(s)

English Language English Literature Mathematics Biology Triple Science


Chemistr y

Additional Science Core Science OCR National Science ICT Language (please state): Technology (please state):

Please tell us about any other interests and hobbies you follow and any qualifications you have, if relevant:

During Year 11 how would you describe your: Attendance: Punctuality: Homework:

Excellent Excellent Excellent

Good Good Good

Fair Fair Fair


Poor Poor Poor

SECTION C – Choice Form

Loxford Sixth Form 2008-2009 Choice Form Choose a 2 year or 1 year course. 2 Year Courses A level choices Please choose 1 (one) from each box A • • • • • • • • •

Biology Chemistry English Literature Accounts ICT (Applied) Media Studies Music Further Mathematics* Government and Politics

* Only if Maths is chosen in option D

B • • • • • • • • •

C • • • • • • • • •

Chemistry Biology Law Computer Science Media Studies Electronics Psychology Maths Applied Science

Physics Business Studies Economics Art History Psychology French Spanish Applied Science

D • • • • • • •

Maths History Drama Geography Philosophy of Religion and Ethics Photography Product Design

If you wish to do Applied Science, it must be chosen in both B and C.

If you have not been able to choose the combination of subjects from A, B, C and D that you wish to study, please write here what you would like to study:

or BTec National Business or Science 1 Year Courses BTEC 1st Diploma Business or National Certificate in Science You will also get the opportunity to do a range of activities including: • • •

Critical Thinking GCSE Re-sits in Maths and English (where necessary) ASDAN Certificate of Personal Effectiveness


SECTION D – Personal Statement In this section please tell us why you want to join the Sixth Form at Loxford School of Science and Technology, why you have chosen your subjects and what plans you have for the future: Continue on a separate sheet if necessary:

Please return the completed form to:

Your Tutor or Sixth Form Applications Loxford School of Science and Technology Loxford Lane ILFORD Essex IG1 2UT E-Mail: For office use only

Date of Application


Ref Sent

Ref Rec’d


Int Date


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