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2021 Online Application Form

Applicant Information

Full Name:*
Date of Birth:*
E-mail Address:*
Current Address:*
Phone (Home):*
Phone (Mobile):*
Have you lived abroad for a period of more than 6 months in the last 3 years?*
If YES, when did you return to the UK?

Parent/Guardian Information

Name of a Parent/Guardian:*
Current Address (if different to above):
Parent/Guardian Postcode:
Parent/Guardian E-mail:*
Parent/Guardian Phone (Home):
Parent/Guardian Phone (Mobile):
Relationship to you:*

Your Educational History

Name of your current school/last school that you attended full time:*
Date of leaving OR date projected to leave: (e.g. August 2021):*
Address of the school named above:*
Please give details about which courses you are studying and your projected or actual grades:

What You Want To Study

Please choose 3 A-Level courses you would like to study, ranking them in order of preference. If you would like to study a fourth A-Level, please choose that too. If you’re not sure, don’t worry – put down what you think you’d like to do and we can discuss this at interview:

First Preference:*
Second Preference:*
Third Preference:*
Fourth Preference:*

Your Motivations And Aspirations

Please explain why you want to study these courses and any career aspirations you may have at this stage? (Max 75 words)*
What attracts you most about applying for a place at Chapeltown Academy? (Max 75 words)*
Please list any enrichment activities that you currently take part in AND any enrichment activities you would like the opportunity to try or continue with at the Academy:*


Please provide details of a referee (most probably a school teacher) who we can contact for a reference:

Referee Name:*
Referee Position:*
Referee E-mail:*
Referee Phone Number:

Optional Questions

We are committed to meeting the needs of all learners. If consider yourself to have any learning difficulties or disabilities, please provide outline details:
To assist with our equal opportunity monitoring, please let us know how you would describe your ethnic origin (e.g. White British):


If you have any extenuating circumstances that you believe we should know about then please attach them to this form. Applications can be scanned and emailed to or posted to Chapeltown Academy Admissions, Chapeltown Academy, Hydra Business Park, Nether Lane, Sheffield, S35 9ZX.

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