KEVICC Kennicott 6th Form Application
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Personal details   First Name *
Surname *
Male/Female
Date of Birth *
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Home Address *
Postcode *
Home telephone *
Student mobile
Student E Mail
Name of Parent/guardian *
Parent/guardian telephone *
Parent guardian E Mail *
Current School name and address (if not KEVICC)
Are you Applying to other Schools or Colleges?
If so please tell us where else you are applying
Please provide predicted grades for all subjects list Subject, Level, and Predicted Grade for each. *
A Level Courses, please choose a maximum of 4
Other Level 3 Courses
Comments; please provide any information you would like to be considered regarding your application including Special Educational Needs.
Declaration: I am applying to Kennicott Sixth Form. I understand that advertised courses will only run if there is sufficient demand and subject to time table configurations. I confirm that the statements made regarding previous achievements are correct and these will be checked as part of the application process.   Student signature; *
Parent signature; *
Date *
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