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Student Details
First Name*
Middle Names
Last Name*
Gender*
- Male
- Female
- Other
Date of Birth*
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Student Age*
When would you like to start your course?*
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SEPT 2024 START DATE*

Day
Month
Year
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AP Start Date 2023*

Day
Month
Year
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ESOL Start Date 2023*

Day
Month
Year
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BOT Start Date 2024*

Day
Month
Year
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SEPT 2024 AGE AT START DATE*
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AP Age at Start 2023*
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ESOL Age at Start 2023*
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BOT Age at Start 2024*
Address*
Type your door number and address to select

Street Address City Postcode
What date did you start living at this address?*
Contact number*
Email*
Enter Email Confirm Email
Did you attend school/college in England*
- Yes
- No
Current school/college name*
Please type in your current school/college name and select
Please select from the following*
- Overseas
- Home School
- Other

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Course Application
Please select your interview type*
- September 2024 Start
- ESOL Adults ONLY Interview
- Alternative Provision Referrals ONLY Interview
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Back On Track Subject Level of interest*
Please choose which programme/subject level you would like to study
Subject of interest*
Please choose which programme/subject area you would like to study
Select 3 A-level subject options. These will be discussed in more detail at interview
Adult Courses*
Please choose which adult course you would like to study
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Back On Track Level 1 / ESOL*
Please choose which course you would like to study
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Back On Track Level 2/GSCEs*
Please choose which course you would like to study
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Back On Track Level 3 Vocational*
Please choose which course you would like to study
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Back On Track A-Level*
Please choose which course you would like to study
1st A-Level*
2nd A-Level*
3rd A-Level*
T-Levels*
A GCSE Maths & English passed at grade 4 or above is required
GCSE Packages*
Maths & English will be added to your study programme if you have not passed at grade 4 or above
Art & Design Course*
Business Course*
ESOL course*
Health, Care & Early Years Course*
ICT Course*
Media Course*
Music Course*
Science Course*
Sport Course*

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Please tell us about yourself
More about you*
Why do you wish to follow this study programme? What are you career aims? What part-time work, work experience and school responsibilities do you have?
Have you attended one of our open evenings?*
- Yes
- No
How did you hear about BSix?*
Which social media do you use the most*
Which messaging type do you use the most*
Reference
Please complete the details below of an appropriate and verifiable 'Referee' from your most recent school/college This can be your previous Teacher, Tutor, Head of Year, etc.
Name of Referee*

This can be your previous Teacher, Tutor, Head of Year, etc.
Job Role of Referee*

This can be your previous Teacher, Tutor, Head of Year, etc
Referee Email Address*
Enter Email Confirm Email

This should be the school/college email address of your previous Teacher, Tutor, Head of Year. If you can't provide the email address of your referee, please put in the general email of your most recent school/college.
Student Data Agreement*
I agree to BSix Brooke House Sixth Form College collecting and processing the personal data contained on this form for any purpose connected with my studies or my health and safety, whilst on college premises, or any other legitimate reason. My consent is conditional upon BSix Brooke House Sixth Form College complying with its obligations and duties under the Data Protection Act 1998. The information provided by me on this application form is accurate.
- I agree

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Student Details