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    UCCA Application For Admission Form 3

    Uploaded by

    Akinlabi Hendricks
    This document is an application for admission to diploma and certificate programmes at The University of the Commonwealth Caribbean. It requests personal information such as name, date of birth, nationality, contact details, education history, source of funding, and requires signatures agreeing to abide by university policies. The application must be submitted along with supporting documents and payment of a J$1000 processing fee to the Office of the Registrar by mail or in person at a UCC Centre.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    UCCA Application For Admission Form 3

    Uploaded by

    Akinlabi Hendricks
    165 views2 pages
    This document is an application for admission to diploma and certificate programmes at The University of the Commonwealth Caribbean. It requests personal information such as name, date of birth, nationality, contact details, education history, source of funding, and requires signatures agreeing to abide by university policies. The application must be submitted along with supporting documents and payment of a J$1000 processing fee to the Office of the Registrar by mail or in person at a UCC Centre.

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    UCCA Application for Admission Form 3

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    This document is an application for admission to diploma and certificate programmes at The University of the Commonwealth Caribbean. It requests personal information such as name, date of birth, nationality, contact details, education history, source of funding, and requires signatures agreeing to abide by university policies. The application must be submitted along with supporting documents and payment of a J$1000 processing fee to the Office of the Registrar by mail or in person at a UCC Centre.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    165 views2 pages

    UCCA Application For Admission Form 3

    Uploaded by

    Akinlabi Hendricks
    This document is an application for admission to diploma and certificate programmes at The University of the Commonwealth Caribbean. It requests personal information such as name, date of birth, nationality, contact details, education history, source of funding, and requires signatures agreeing to abide by university policies. The application must be submitted along with supporting documents and payment of a J$1000 processing fee to the Office of the Registrar by mail or in person at a UCC Centre.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    Application for Admission

    Diploma and Certificate Programmes

    INSTRUCTIONS: Please complete all sections of this form.


    • Answer ALL sections in BLOCK CAPITALS.
    • One (1) passport size photograph and a copy of birth certificate should accompany this form.
    • Attach all supporting documents with proof of education and training and proof of work experience.
    • A non-refundable processing fee of J$1000.00 should be paid.
    PLEASE NOTE: PLEASE AFFIX
    • A course may be cancelled if there is under-enrolment.
    YOUR PHOTO
    We encourage you to apply online at www.ucc.edu.jm.
    You may also apply by completing and submitting your application form and supporting documents to a UCC Centre or by
    mailing them to: Office of the Registrar, The University of the Commonwealth Caribbean, 17 Worthington Avenue, Kingston 5.

    Select campus/host school for study:

    UCC Main Campus - KINGSTON UCC Centre - OCHO RIOS


    UCC Centre - MAYPEN UCC Centre - MONTEGO BAY
    UCC Centre - MANDEVILLE UCC Centre - SAVANNA-LA-MAR

    SECTION A: Programme | Semester


    1 Programme for which you are applying 2 State the semester and the year you intend to commence
    your programme
    _____________________________________________________
    First Option
    October ( 20___ )
    _____________________________________________________
    January ( 20___ )
    Second Option

    3. Do you have access to high speed internet? No Yes Home Other __________________________________________

    SECTION B: Personal Data


    1 LAST NAME FIRST NAME MIDDLE NAME

    MAIDEN NAME 2 DATE OF BIRTH 3 GENDER


    (dd/mm/yyyy)

    4 MARITAL STATUS Single Divorced 5 NATIONALITY 6 EMAIL ADDRESS


    Married Widowed

    7 HOME NUMBER MOBILE NUMBER WORK NUMBER

    8 MAILING ADDRESS 9 PERMANENT ADDRESS (if different from mailing address)

    9 10 TAXPAYER REGISTRATION NUMBER (TRN):

    11. Do you have any physical disabilities? No Yes ( Please state ) __________________________________________

    SECTION C: Source of Funding


    1 2
    What is your source If receiving sponsorship:
    of funding? a. Organization: _________________________________________________________________________________
    b. Authorising Personel:___________________________________________________________________________
    Self
    Parent c. Position: _ ____________________________________________________________________________________
    Local Loan d. Telephone #: __________________________________________________________________________________
    Overseas Loan e. Level of Sponsorship:
    Sponsorship
    Complete Partial (amount) $ ______________________

    Signature: _________________________________________
    SECTION D: Education background
    HIGH SCHOOL ATTENDED SUBJECTS PURSUED YEAR AWARD (CXC, O’LEVEL) RESULT

    SECTION E: Parent/Guardian Consent


    (This is required if you are younger than 18 years of age)

    NAME OF PARENT/GUARDIAN RELATIONSHIP TO APPLICANT

    ADDRESS

    TELEPHONE NUMBER

    DATE

    SIGNATURE

    SECTION F: Applicant’s Declaration

    1. My signature certifies that I agree to abide by the policies, rules and regulations of the institution.
    2. I also understand that the institution reserves the right to suspend or dismiss any student at anytime for disciplinary misconduct or when
    such an action is deemed to be in the best interest of the student and student body.
    3. I understand that withholding information requested or falsification of information given will result in the disciplinary action and
    make me ineligible for admission and enrollment.

    APPLICANT’S SIGNATURE DATE

    REFER A FAMILY MEMBER / FRIEND / WORK ASSOCIATE

    Please enter their contact information below.

    NAME TELEPHONE NUMBER EMAIL ADDRESS

    FOR OFFICIAL USE ONLY

    Decision: Full Acceptance Denied


    Provisional Acceptance Outstanding Requirements: _ ___________________________________________________________________________
    Remarks: _________________________________________________________________________________________________________________________

    _________________________________________________________________________________________________________________________________

    NAME OF ADMISSIONS COMMITTEE REPRESENTATIVE SIGNATURE DATE

    NAME OF ADMISSIONS OFFICER SIGNATURE DATE

    UCCA RECRUITER
    NAME ID NUMBER

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