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/MuST. 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.

THIS COLUMN IS FOR OFFICIAL USE ONLY

Date Received:

Trainee ID#:

Remarks:

Accepted? Yes No

Placement Officer’s Signature:

Date

Are you presently employed? Yes No

Do you have a Disability or Medical Condition? Yes No If yes, please state medical condition: ___________________________

EDUCATION/ TRAINING COMPLETED:

Primary Junior Secondary Secondary Youth Camp YTEPP

HYPE MIC Trade School Other __________________

Address

REGION: NORTH EAST CENTRAL SOUTH TOBAGO

Tel. No. (Home) (Cell)

Email Sex: Male Female

Multi-Sector Skills Training (MuST) ProgrammeHOSPITALITY & TOURISM Level IAPPLICATION FOR ADMISSION

Surname

First Name

Other Name

Date of Birth Birth Certificate PIN# Age

I.D. PP# D.P. # NIS #

DAY MONTH YEAR

ENTRY REQUIREMENTS:• Applicant must be an unemployed

national/resident of Trinidad & Tobago • Between the ages of 17-50 years• Copy of National Identification Card or

Passport• Copy of electronic Birth Certificate• Two Passport sized photos

SUBMIT THIS APPLICATION FORM

AT ANY OF THE FOLLOWING OFFICES

EMERGENCY CONTACT

Name Relationship

Address

Tel. No. (Home) (Cell) Email

• Become certified to Regional Occupational Standards (ROS) and achieve the Caribbean Vocational Qualification (CVQ)• Gain practical experience by training on actual Hospitality & Tourism locations.

• Trainees receive: Daily Stipend, Insurance Coverage, Basic Hand Tools & Personal Protective Equipment (PPE)

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Visit us @ www.mic.co.tt

How did you learn about this programme?

Radio T.V.

Press

Promotion Event

Other _____________________________

Ex-Trainee

Social Media

Community Outreach

Head Office 5A Century Drive, Trincity Business Park, MacoyaTel: 663-4642 ext. 3299, 3298Fax: 221- 5247

NORTH: Laventille Technology Centre, Eastern Main Road, Laventille ...625-1240 / 1076EAST: O’Meara Technology Centre, Lot 68, O’Meara Business Park...663-4642 ext. 3244 / 3276CENTRAL: Chaguanas Technology Centre, Montrose Main Road (Upstairs Mario’s)...672-5793 / 222-6886SOUTH: Ste. Madeleine Technology Centre, Daisey Road, Ste. Madeleine...698-2469 / 652-4595 ext. 4048 / 4035TOBAGO: Tobago Technology Centre, 143 Milford Road, Canaan...631-1300 ext. 5046