Apply online via our
application form or
download our PDF form

Brine leas Sixth Form

Audlem Road
Nantwich
Cheshire
CW5 7DY

T. 01270 625663
F. 01270 610373
E. info@bl6.org.uk

Directions

Design by GSD®

Online Application Form

Required fields indicated (*)

Welcome to the BL6 online application form.
Please complete the following sections as accurately as possible.
Required fields are marked throughout (*), and must be completed before submission.

Use the arrows to the left and right of the page to navigate through the sections.
Your Details
Forename(s): *

Surname: *

Date of Birth: *

Email:

Home Address: *

Postcode: *

Telephone: *

Mobile:
Parent / Guardian Details

Title (Dr/Mr/Mrs/Other): *

Initial and Surname: *

Email:

Home Address: *

Postcode: *

Telephone: *

Mobile:
School Details

Present School:

School Postcode:

Did you attend our open evening in October or any of our information events?
Subjects currently being studied in Year 11
Subject:Qualification:Estimated Grade:

1:

2:

3:

4:

5:

6:

7:

8:

9:

10:

11:

12:
Results of examinations already taken (if applicable)
Subject:Qualification:Estimated Grade:

1:

2:

3:

4:

5:

6:
Main Course Choices (in order of preference)

First Choice

Second Choice

Third Choice

Fourth Choice

Reserve Choices

Fifth Choice

Sixth Choice:

Comments:
Extra-curricular

Positions of responsibility held in or out of school

Games, sports teams involvement and/or musical accomplishments or interests

Please give further information about general interests, achievements in activities outside of school

Any career thoughts?
About your application

Have you ever had special arrangements in examinations?

If yes, then what were the arrangements?

How many other institutions are you applying to?
We will respond to your online application with a completed application form which will still need to be signed by both you and your parent/guardian' before your application is finalised.