Dereham Sixth Form College and DESA Application Form
Please use this form to apply for courses to start in September 2021. All course information is available in the Prospectus section of our website.
Personal Details
Forename *
Surname *
Other Name *
Have you already applied through HelpYouChoose? *
Date of birth *
Current High School *
Email *
Mobile phone *
Home phone *
Home Address *
Please state your nationality *
Have you lived in the UK or EU for the past 3 years? *
If no, date of entry to into the UK or EU
Do you have any immigration restrictions?
Clear selection
Are you a registered asylum seeker?
Clear selection
Have you lived abroad within the last 3 years because family is in the British Armed Forces? *
Equal Opportunities
Clear selection
Is English your first language? *
Are you looking after someone at home? *
Are you currently, or have you recently been living in care?
Clear selection
Ethnicity *
Emergency Contacts
Name of First Emergency Contact: *
Relationship to you: *
Daytime Phone: *
Evening Phone: *
Address if different from home address above:
Name of Second Emergency Contact:
Relationship to you: *
Daytime Phone *
Evening Phone
Address if different from home address above
Educational History
Are you still attending school? *
If no, please enter the date you left
Name of current high school *
Year and form group *
Head of Year/House
Start date
Qualifications and Predicted Grades (please state if not GCSE)
If these are not GCSEs please give details
Personal Statement
Do you have an intended career or career interests?
Have you completed any relevant Work Experience in relation to your long-term career interests?
Extra-curricular activities you've done at school
eg. Prefect, clubs, sporting activities etc
Do you require further information on transport services to Dereham?
Clear selection
Course Choices
Please enter a minimum of 3 and a maximum of 5 courses. Subjects are timetabled in blocks - only choose one subject in a block unless instructions say otherwise.
A Levels/BTEC you would like to apply for: *
Never submit passwords through Google Forms.
This form was created inside of Dereham Sixth Form College. Report Abuse