Which pathway are you applying for?(Required)

Why are you applying?(Required)

Please tell us why you want to apply to the Academy Grimsby or if you have any questions:

Student Name(Required)

Title First Last

Student Date of Birth(Required)

Students Gender(Required)

Male

Female

Prefer not to say

Other

Students Current School(Required)

Students Current Year Group(Required)

If other please fill in the name of the school or academy here

Parent/Carers Name(Required)

Title First Last

Address of your child(Required)

We check addresses and you must expect that we will withdraw our offer of a school place if you give a false address

Street Address City/Town Postcode

Parent/Carers Phone Number(Required)

Parent/Carers Email(Required)

Parent/Carers Relationship to the student/child(Required)

Are you in care or a care leaver?

Yes

No

Do you have any medical conditions/disablement?

Yes

No

If yes select from the list

Do you have a learning difficulty?

Yes

No

If yes select from the list

Do you have a Special Educational Needs (SEN) statement?

Yes

No

Additional information

Courses you have taken

Course

Type (GCSE, A Level)

Predicted Grade

Actual Grade

Completion Date

Where did you hear about our courses?

Agree?(Required)

If you deliberately give false information, we may withdraw our offer of a school place.All of the information I have given on this form is correct, I understand that you will inform my child's current school of this application.I understand that if I accept a place at the Academy Grimsby my child's current school place will be withdrawn at the end of this academic year (July ) and may be re-allocated to another child.I confirm I have parental responsibility for this child, I have discussed this application with all who have parental responsibility I agree and understand to the terms and conditions above.

Yes

Terms & Conditions(Required)

I agree to the Terms & Conditions and understand that academy.grimsby.ac.uk has a legitimate interest to process the data that I have submitted. See our Terms and Conditions and Privacy Policy for more information. This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Yes

Email

This field is for validation purposes and should be left unchanged.

Application Form