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SECTION 5: PERSONAL STATEMENT

Write an essay that will help us become acquainted with you in ways different from courses, grades, and other objective data and the reason for your choice of this institution.

ST. JOSEPHS TEACHERS COLLEGE


16 Old Hope Road, Kingston 5, Jamaica, West Indies, 876-926-6659

APPLICATION FORM

BACHELOR OF EDUCATION DEGREE


ACADEMIC YEAR ______ /______
INSTRUCTIONS 1. 2. Complete Form in BLOCK CAPITALS, LEGIBLY and ACCURATELY. Forms not properly completed will not be processed. Return completed Application Form to the College.

PHOTO

Please specify the programme that you intend to pursue


EARLY CHILDHOOD EDUCATION
Bachelor Degree in

PRIMARY EDUCATION

Bachelor Degree in

PART TIME
(Evening)

FULL TIME
(Day)

SECTION 1: PERSONAL DETAILS


Surname: (BLOCK CAPITALS) Middle Name(s) Gender: Male Marital Status: Female Date of Birth: Maiden Name: Christian Name:

Emergency Contact:
Name: Address: Occupation: Phone No: Relation to you:

National of: Home Address: Street: Country: Postal Address Street (if different): Country: Place of Birth: Country: Mother's Name: City/Parish: Phone No: City/Parish: Phone No: City/Parish: Email Address: Fathers Name:

Mother's Maiden Name: Mother's Occupation:

Father's Occupation:

I hereby certify that I have read and understood the instructions and the information necessary for completing this application. I acknowledge that the information given in this application is complete and accurate.

Religious Affiliation / Denomination: Does your religion prevent participation in any of the following activities? Physical Education Daily College Worship Christmas Lunch If yes, please explain: Yes Yes Yes No No No Music and Movement Chapel Service Graduation Yes Yes Yes No No No

Signature:

Date:

Witness:

Date:

SECTION 2: ACADEMIC RECORD

Institutions Attended Reference 3


School Name / Type Street / District Parish / City Country From To Name: Address: Phone No: Relation to you: Occupation: Will you be able to fulfill your financial obligations? Yes No If yes, please state your source of income: Salary Student Loan Credit Union State Bank Loan CSJP Other

Qualifications
*Status Examining Body Subject Area Grade Date
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*Status = Obtained / Pending / Sitting

Are you willing to comply with: (A) dress code? (B) deportment regulations? Yes Yes No No

SECTION 4: JOB HISTORY


School Name / Type Street / District Parish / City Country From To

SECTION 3: ACTIVITIES & REFERENCES


Offices Held: Games Played: Hobbies:

Please give three references below: Reference 1


Have you ever had any teaching experience?
Name:

Yes

No

State total years of teaching experience:


Address: Phone No:

If you have left school, have you been working since leaving? If no, what have you been doing?

Yes

No

Clubs: Responsibilities/Duties:

Relation to you: Occupation:

Reference 2
Name: Address: Phone No: Relation to you: Occupation:

Do you play a musical instrument? If yes, please state: