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27. a) Are you a UWI Staff Member? If yes, state: b) Staff Identification Number: Yes o ___________________________________ ___________________________________ c) Campus/NCC: d) Department: ___________________________________

29. a)

Do you wish to live in a Hall of Residence? b) If yes, state Hall

28. a)

b) c) d) e)

Are you a dependent of a UWI Staff Member? If yes, state: Name of Staff Member:

Yes

No

_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Relationship to applicant: Campus/NCC: Department: _____________________________________ c) If no, state preference for Hall attachment

(see Instruction

____)

Yes

No

30. How did you obtain information about the UWI?

UWI Alumni

Direct Mail

School/College Fair

School Visit

Employer O t h e r : P l e a s e s p e c i f y _ _ Internet _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Media

31. Faculty of First Choice Engineering Gender & Development Studies Humanities & Education Law Medical Sciences Pure & Applied Sciences Science & Agriculture Social Sciences

OR

Cave Hill

Degree

Full Time

Mona

Tertiary Level Institution

Diploma

St. Augustine

Distance

Certificate

Part Time

SECTION B – CAMPUS, FACULTY, PROGRAMME & STATUS

For Faculty of First Choice, indicate the following:

33. Programme

34. Status

Associate Degree

UWIDEC

Please state Preferred Site OR SCS UWI Centre

SCS

_______________________

32. a) Campus

b) Mode of Delivery

(UWIDEC Applicants only)

35. First Preference Major

36. Second Preference Major

School of Continuing Studies 37. Faculty of Second Choice Engineering Gender & Development Studies Humanities & Education Law Medical Sciences Pure & Applied Sciences Science & Agriculture Social Sciences

OR

Cave Hill

Degree

Full Time

Mona

Tertiary Level Institution

Diploma

St. Augustine

Distance

Certificate

Part Time

For Faculty Second Choice, indicate the following:

39. Programme

Associate Degree

40. Status

UWIDEC

Please state Preferred Site OR SCS UWI Centre.

SCS

_______________________

38. a) Campus

b)Mode of Delivery (UWIDEC Applicants only)

41. First Preference Major

42. Second Preference Major

School of Continuing Studies

SECTION C – ACADEMIC RECORD 43. List all subjects passed at CXC (CSEC) General Proficiency, CXC (CAPE) and GCSE Ordinary and Advanced Levels

Examining Body (e.g. CXC, Cambridge)

Level

Subject

Grade

Date Awarded (mm/yyyy)

CXC (CSEC) General Proficiency and GCSE Ordinary Level subjects passed

CXC (CAPE) Unit 1 & Unit 2 and GCSE Advanced Subsidiary & Advanced Level subjects passed

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