SSWL Post 16 APPLICATION FORM

Space Studio West London Post 16 Application Form
Student Details:
Full Name

First Name Last Name
Date of Birth *

Day Month Year
Gender: *
Home Telephone *
Mobile Telephone

Address *

Street Address Line 1
Street Address Line 2
City	State / Province
Post Code	Country

Email *
Please ensure your email address is correct
Current School *
GCSE Subjects:
Subject and Grade (predicted or actual):
Subject and Grade (predicted or actual):
Subject and Grade (predicted or actual):
Subject and Grade (predicted or actual):
Subject and Grade (predicted or actual):
Subject and Grade (predicted or actual):
Subject and Grade (predicted or actual):
Subject and Grade (predicted or actual):
Subject and Grade (predicted or actual):
Subject and Grade (predicted or actual):
Subject and Grade (predicted or actual):
Subject and Grade (predicted or actual):
Academic Programme:
Pathways

There are three pathways you can choose from:

Pathway 1: Technical and Scientific Route

Careers such as skilled technicians, operators, engineers, scientists,

inventors, and entrepreneurs in aerospace and space related industries.

Pathway 2: Enterprise and Organisational Career Route

Develop both organisational skills and an enterprising outlook designed to

provide them with management and organisational careers in aerospace and space industries.

Pathway 3: Gastronomic Science Career Route

Careers such as food scientists, food hygienists, food manufacturers, food packagers,

caterers and restauranteurs. (The Food & Drink industry is the largest in the UK)

Please choose one pathway and select from it the A Levels you want to study:
Pathway 1

Applied Science (BTEC) Biology Chemistry Computer Science English Food Science & Nutrition (BTEC) Further Mathematics History IT (BTEC) Maths Physics Psychology
Pathway 2

Applied Science (BTEC) Aviation Operations (BTEC) English Enterprise & Entrepreneurship (BTEC) Further Mathematics Geography IT (BTEC) Maths Psychology
Pathway 3

Applied Science (BTEC) Biology Chemistry English Food Science & Nutrition (BTEC) IT (BTEC) Level 3 Professional Cookery Maths
Career Choice/Area of Interest:
Please let us know if there is any other course of type of qualification that you would be interested in studying:
Learning Support:
Do you have a learning disability, sensory impairment or medical condition?

Yes No
Do you have a Statement of Special Educational Needs?

Yes No
If Yes, please give details:
Do you feel that you will need extra support in your studies for any other reason?

Yes No
If Yes, please give details:
Additional Information:
Name of parent/carer: *
Relationship to applicant:
How did you hear about us? *
Eg. bus advert, magazine, radio, Facebook, from a friend
DECLARATION

I certify that the information I have provided is correct to the best of my knowledge. I understand that the completion of this form does not automatically guarantee me/my child a place at Space Studio West London and I understand Space Studio West London reserves the right to amend course details as published.
Applicant signature (use your mouse to "draw" your signature) *
Date *

- Day - Month Year
All applicants who meet the minimum requirements will be invited for an interview before they are offered a place.
Should be Empty:

Student Details:

GCSE Subjects:

Academic Programme:

Learning Support:

Additional Information: