Distinction College Application Form 1

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DISTINCTION COLLEGE

Spanish Town: (876) 648-5080/354-8560/Kingston: (876) 668-7000/356-4167/Ocho Rios: (876) 539-0945


Ensure that the application is FULLY completed using CAPITAL letters. Applicants are responsible for ensuring that all supporting documents are submitted with this form.
SECTION A-PERSONAL DATA
Date:________22/12/22_____________________ Address:____Mike_Town
Mandeville_________________________________________________
Last Name:
_____________________________________________________________
Weller _________________________________________________
Parish:__Manchester______________________________________
First Name:
__
Charlene_________________________________________ Tel #: 876 203-5152
Middle Name_Stacey- Email:_charlene_______________________________________
TRN#:____114364648___________________________NIS#:________________
Ann__________________________________ Occupation:____NA______________________________________________________
Date Of Birth:__11____/___01_______/__1985_________ ___
Age:_____37_____ Gender: Female Male
DD MM YYYY Marital Status: Married Single Other:____________________
Nationality:___Jamaican____________________________

SECTION B-NEXT OF KIN


Last Name:__Love____________________________________
First Name Tel
Lovel_____________________________________________ #:__8768126327__________________________________________
Address:_same as _____
above______________________________________________________ Relation:__Husband____________________________________
__________________________________________________
______________________________________________________________________________________________________________________________________________________________________
SECTION C-EDUCATION
Last School Attended:__UWI open Campus______________________________3 Mths course_______Period
attended:______________-______________
Certificate/subjects obtained:__Housekeeping and and
Computerliteracy________________________________________________________________________________________________________________
__________________________________________________________________________________________________________
Have you ever attend Distinction College: YES NO
If yes state location:____________________________________ course/subject:_________ ___________________________________________________________
_________________________________________________________________________________________________________________________________________________
SECTION D –COURSE/SUBJECT (C.XC/CAPE/CITY & GUILDS) to be done at Distinction College
______________________________________ ________________________________ ________________________________
______________________________________ ________________________________ ________________________________
______________________________________ ________________________________ _____________________________

What mode of teaching do you prefer?

Online classes Face to Face Classes

SECTION E- HEALTH
Do you suffer from any of the following? Allergies Diabetes Depression/Mental Illness Epilepsy
Seizure disorder Asthma
Other:_____________________________________
SECTION F-FINANCIAL
How will be responsible for your fees? Self Student loan PATH Other:_______________________________________
SECTION G-MEDIA
How did you learn about us? TV Radio News Paper/AD’s Flyers Directory Friend Student

Other ________________________________
I have completed this form having read and understood the rules of the institution and will abide by these rules.
Student Signature:_________________________________________________________________________________________________________________ ________________

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