First Name: (required) Last Name: (required) Your Email: (required) Date of Birth: Current Address: Name of Parent with Parental Responsibility: Name of Current School: (required) Address of Current School: (required) Name of Referee: (required) Predicted GCSE Grade for English Literature: (required) Predicted GCSE Grade for English Language: (required) Predicted GCSE Grade for Mathematics: (required) Please select the courses you would like to take: ArtBiologyBusinessChemistryComputer ScienceDanceEnglish Literature & LanguageFrenchGeographyHistoryMathematicsMusicPhysical EducationPhysicsProduct DesignReligious Studies Do you have a disability, learning disability or any medical condition? If yes please state below: YesNo Please state your disability, learning disability or medical condition below: Is HTA Sixth Form your first choice of place to study? Religious Background: Catholic children who are looked after or previously looked afterBaptised Catholic childrenNon-Catholic children who are looked after or previously looked after*Non-Catholic children Residency: am a UK citizen or have been ordinarily resident in the UK and Islands for the full three-year period before the first day of the first academic year of the course, i.e. from 1 September 2015 to 31 August 2018 If neither of the above residency statements apply, please give details of your residency: Please prove you are human by selecting the House. All personal data will be processed in full compliance with the Data Protection Act 1998. Personal data will only be processed to support your application.