Applicant's Information:

First Name:* Surname:* Date of Birth:* Parental Contact 1 - phone number and email address* Parental Contact 2 - phone number and email address*

School and Qualifications:

Current School Current Year Referee 1 (This must be your current Head of Year) Name and contact details.* Referee 2 Name, contact details and relationship to you.* Subject and Grade information - please tab along to complete fully.

	Subject	Grade achieved	Grade predicted	Date the result was achieved. For exams not yet taken enter 'Summer 2022'

Subject Choices - please select from 1 of the 3 options:

Option 1 - To follow an A Level only Programme of study please select 3 subject choices:

Subject Choice 1 Subject Choice 2 Subject Choice 3 Option 2 - To follow BTEC sport or a combination of BTEC sport and A levels, please select one pathway below: - Study only BTEC Extended Diploma in Sport which is equivalent to 3 A Levels - Study one or two A Level subject and the BTEC Diploma in Sport:

	BTEC Extended Diploma (equivalent to 3 A levels)	BTEC Diploma and One A Level (please indicate A Level choice)	BTEC Diploma and Two A Levels (please indicate A Level choices)	3	4	5
Select 1

Option 3 - To follow the BTEC Vocational in Childcare or Professional Cookery: - Study only BTEC Extended Diploma which is equivalent to 3 A Levels - Study one or two A Level subject and the BTEC:

	BTEC Extended Diploma	BTEC Diploma and One A Level (please indicate A Level choice)	BTEC Diploma and Two A Levels (please indicate A Level choices)	3	4	5
Select 1

Wealdstone FC/THA Football partnership programme:

For the Football programme, training sessions will be added automatically to your timetable Students following BTEC sport will have all training sessions added to their timetable. Students following A levels or a combination of A levels will be accommodated as far as possible to participate in all football training sessions. For some combinations of subjects, there can be a clash which will be addressed on a case by case basis. Please indicate clearly below if you are applying for a place on the Football partnership programme. Please indicate clearly (external applicants only) where you heard about this programme.

Do you wish to be part of the Wealdstone FC/THA Football partnership programme?*YesNo

Have you attended a Wealdstone FC/THA Football partnership programme trial?*YesNo

Where did you hear about the Wealdstone FC/THA Football partnership programme?

To follow the Btec Vocational in Childcare or Professional Cookery

Study only Btec Extended Diploma which is equivalent to 3 A Levels /Study one or two A Level subject and the Btec

	Btec Extended Diploma	Btec Diploma and One A Level (please indicate A Level choice)	Btec Diploma and Two A Levels (please indicate A Level choices)	3	4	5
Text 1

Special/Educational Needs:

Please complete the tables below with any special educational, exam access arrangements or medical needs.

Special Educational Needs: Exam Access Arrangements: Medical Needs:

Reason for Applying to The Harefield Academy Sixth Form

Please complete with a brief statement of why you are applying to our Sixth Form.*

Successful applicants may be contacted for an interview and will be sent an offer letter on receipt of references. Thank you for your application and we look forward to welcoming you to our Sixth Form.

Please enter

Online Application - NON THA STUDENTS

Exam Certificates 2021-22

The Harefield Academy

Achievement through Active Learning