THIS COLUMN IS FOR OFFICIAL USE ONLY

Registration Number

ST. BEDE TECHNOLOGY CENTRE

JOINERY (Level II)APPLICATION FOR ADMISSION

Have you previously been a student of this Institute? If the answer is YES state:

(a) Period: from to

(b) Course followed

Are you applying for full time or evening shift?

Full Time (1 ½ year | Mon-Fri | 8am - 4pm)

Part Time (2 years | Mon-Fri | 5pm - 9pm)

EDUCATION

Name of School(s) attended

Examining BodyG.C.E., C.X.C.,N.E.C., etc.

Level of ExaminationGeneral/Basic“O” / “A” Level

PLEASE ATTACHPASSPORT SIZE

PICTURE

Surname

First Name

Other Name

Address

Tel. No. (Home) (Cell)

Email

Date of Birth Sex: Male

Female

Place of Birth Nationality

I.D. / Passport / D.P. No.

DAY MONTH YEAR Age

PPE BOOT SIZE

COVERALL SIZES,M,L,XL,XXL

Info

rmat

ion

give

n m

ust

be

accu

rate

and

cle

arly

wri

tten

in B

LOC

K le

tter

s. T

ick

whe

re n

eces

sary

.

Visit us @ www.mic.co.tt

Rev

: Jan

.201

9

How did you learn about this programme?

Radio T.V.

Press

Promotion Event

Other _____________________________

Ex-Trainee

Social Media

Community Outreach

ENTRY REQUIREMENTS:• National/resident of Trinidad & Tobago,

minimum age of 17 years• CVQ in Secondary School, Carpentry

Level I Certificate OR MIC-IT HYPE OR MuST Carpentry Certificate

• Completion of Level I Carpentry from a recognized TVET Institution OR Equivalent Work Experience

• Copy of National Identification Card• Copy of electronic Birth Certificate• Two Passport sized photos

HEAD OFFICE5A CENTURY DRIVE, TRINCITY BUSINESS PARK, MACOYA.Tel: 1 (868) 663-4642 ext. 3130Fax : 1 (868) 663-6055

ST. BEDE TECHNOLOGY CENTRESt. John’s RoadMT. ST. BENEDICTTel: 1 (868) 645-6702

WORK EXPERIENCEName of Employer

FOR

OFF

ICIA

L U

SE

ON

LY

EXTRA CURRICULAR ACTIVITIES(a) List Teams, Clubs or Groups to which you belong

(b) List Sports in which you take part

(c) Hobbies

Acknowledgement

Entrance Test

Interview

If Accepted-Date Notified

Registration Fee- Receipt No.

Caution Fee- Receipt No.

Group Accident Insurance Premium-Receipt No.

Date of Admittance

By

Result

Time If Rejected - Date Notified

Dated

Dated

Dated

Post held by you From To Monthly Salary Reason for Leaving

-Date

-Date

-Date

Date Bursar/Registrar

PLEASE SUBMIT APPLICATION FORM AT

ANY OF THE FOLLOWING CENTRES

Date

DECLARATION OF APPLICANT PLEASE READ CAREFULLY BEFORE SIGNING

Signature of Applicant

I certify that all information contained in this application is true and correct to the best of my knowledge. I agree to abide by the rules and regulations of MIC-IT. I understand that falsifying any part of this application may result in rejection of the application or termination of my registration with the institution.

NOTE: THIS APPLICATION IS NOT CONSIDERED COMPLETE UNTIL THIS DECLARATION HAS BEEN SIGNED AND DATED.

Name Relationship

Address

Tel. No. (Home) (Cell) Email

EMERGENCY CONTACT (Parent, Guardian or Next of Kin)