Blank GSA Salter Sixth Application Form Sept 2022 1

GEORGE SALTER ACADEMY
Davey Road
West Bromwich
West Midlands, B70 9UW
T: 0121 553 4665 Ext. 5233
APPLICATION FOR POST-16

SEPTEMBER 2024
Deadline: 31 January 2024
PERSONAL DETAILS
Please read the guidance notes carefully and complete using black ink, writing clearly.
Surname: Forenames:
Gender: DoB (dd/mm/yyyy):
Your Mobile No: Parent/Carer
Mobile no:
Home address:
Postcode:
Your E-mail Parent/Carer
address: E-mail address:
Present school:
We will send you an e-mail confirming receipt of your application form and important information relating to admissions
events.
If you DO NOT wish to receive an e-mail acknowledgement or updates, please tick this box: ◻
Do you hold, or are you eligible to hold, a UK or EU passport? Yes ◻ No ◻
EQUAL OPPORTUNITIES
Please note that the data gathered via our application paperwork is used, confidentially, to ensure all applications are treated fairly as
regards the Equality Act. The Learning Support information helps the Academy understand any specific needs, and hence determine
and make any reasonable adjustments required in advance of students attending for interview. All applicants are considered on the
basis of potential to benefit from a place at the Academy.
White: Asian/Asian British:

◻ British
◻ Indian
◻ Irish
◻ Gypsy or Irish Traveller
◻ Pakistani
◻ Any other White background
◻ Bangladeshi
Mixed/Multi Ethnic group:
◻ White and Black Caribbean ◻ Nepali
◻ White and Black African
◻ White and Asian ◻ Chinese
◻ Any other mixed/multiple ethnic
◻ Any other Asian background
Other Ethnic Group:
◻ Arab Black/African/Caribbean/Black British:
◻ Any other Ethnic group
◻ African
◻ Caribbean
◻ Other Black/African/Caribbean
Alternatively:
◻ Prefer not to say
All students: Do you have any learning support or other needs e.g. Dyslexia, Hearing, Visual or Mobility. Please tick box A
or B. If yes, please provide further details at the end of this document.
A. Yes ◻
B. No ◻◻
CAREER AND/OR UNIVERSITY ASPIRATIONS:

Please describe your career/university aspirations:
SUBJECT CHOICES
Please list FOUR subjects in the table below in order of preference. The first subject being the first choice. You will have the chance to
change your mind throughout the admissions process.
Subject How strong is your desire to study this subject?

Definitely  Probably  Possibly 
GCSE SUBJECTS
Subject Your grade prediction Teachers grade Grade if already achieved
prediction
English Language
English Literature
Mathematics Higher*
Mathematics Foundation*
Triple Award Science **
Double Award Science**
Applied Science**
Science – other**
OTHER QUALIFICATIONS (BTEC, OCR NATIONALS ETC)

Subject Equal to how many Your grade Teachers grade Grade if already
GCSEs? prediction prediction achieved
2
* Enter details for EITHER Higher or Foundation Level Mathematics.
** Enter details for EITHER Triple Award Science, Double Award Science, Applied Science or
Other Science.
NOTES
PERSONAL STATEMENT
Please comment on your achievements in and out of school, what you can offer George Salter Sixth Form, and reasons for your choice
of subjects/courses together with your long term career plans.
Signed: ……………………………………………………………….. Date:…………………………………………………..
3
REFERENCE
Please complete the name of your Head of Year, Head of House or Tutor.
Name: School:
Acknowledgement of
application:
APPLICATION PROCESS Date of meeting sent:
1. Attend Post-16 Open Evening INTERNAL STUDENTS

HoH/Tutor reference:
2. Collect Information on Subjects, Prospectus, and Positive/negatives:
Application Form.
Attendance:
Go4Schools report:
3. Complete Application Form and submit to Post-16 Office.
Subject staff contact before
meeting:
4. Application acknowledged and a date for interview
Subject staff contact after
confirmed (note: reference requested for external
meeting:
students).
PL informed of outcome of
5. Formal meeting held with student meeting:
and parent/guardian. Decision will be made, either: Contract review date:
Decision based on contract:
a) Student will be offered an unconditional
place. EXTERNAL STUDENTS
b) Student will be offered a conditional place, Reference request:
dependent on attendance or behaviour Date reference requested:
contract – review to be carried out on a Date reference received:
specified date in the future. Attendance at welcome day:
c) Student will be offered a conditional place, MEETING (1)

dependent on specific GCSE grades.
Date:
d) Student will be recommended to study Interviewer:
elsewhere. Attendance: Present No-Show
6. Welcome day for external students.

RESULTS DAY MEETING (2)
7. Acceptance/rejection of offer of place by
student.
8. Taster sessions attended in Jun/July.
9. GCSE Results and enrolment.
10. Registration and confirmation of timetable.
11. Start of Autumn term.
FOR OFFICE USE ONLY

Date application received:
4
Date:
Interviewer:
Attendance: Present No-Show
Offered place: Y N
Destination:

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GEORGE SALTER ACADEMY

APPLICATION FOR POST-16

Do you hold, or are you eligible to hold, a UK or EU passport? Yes ◻ No ◻

White: Asian/Asian British:

CAREER AND/OR UNIVERSITY ASPIRATIONS:

Subject How strong is your desire to study this subject?

OTHER QUALIFICATIONS (BTEC, OCR NATIONALS ETC)

Signed: ……………………………………………………………….. Date:…………………………………………………..

1. Attend Post-16 Open Evening INTERNAL STUDENTS

c) Student will be offered a conditional place, MEETING (1)

6. Welcome day for external students.

8. Taster sessions attended in Jun/July.

9. GCSE Results and enrolment.

10. Registration and confirmation of timetable.

11. Start of Autumn term.

FOR OFFICE USE ONLY

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