Registration Form
Fill out the form carefully for registration. A non-refundable deposit of EC$30.00 MUST be paid before your registration can be processed.
Student Name
*
First Name
Middle Name
Last Name
Birth Date
Please select a month
January
February
March
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June
July
August
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Month
Please select a day
1
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31
Day
Please select a year
2026
2025
2024
2023
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1928
1927
1926
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1924
1923
1922
1921
1920
Year
Gender
Please Select
Male
Female
N/A
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student E-mail
*
example@example.com
Mobile Number
Phone Number
Work Number
Religion
Last School Attended
Grade or Level Completed
Qualifications (CXC)
Other Certificate(s) Attained
Present Employment
Number of Child/Children
How were you informed of the program?
Friend
Radio
Flyer
Other
Hobbies/pastime
Do you have access to a computer?
Yes
No
Have you taken any computer courses before?
Yes
No
Please state
Back
Next
Please select the appropriate course of interest
*
General Office Administration Level 2
Accounting Clerk Level 2
Customers Service Level 2
Reception Level 2
Graphic Design Level 2
Business Administration Level 2
Customs Services Level 2
Radio Broadcasting (Journalism) Level 2
Teacher Assistant Level 2
Early Childhood Level 2
Payroll Administration Level 3
Administrative Assistance Level 3
Accounting Level 3
Marketing Level 3
Management Level 3
Customs Services Level 3
Human Resource Management Level 3
Small Business Management Level 3
Real Estate Services Level 3
Executive Secretary Level 4
Paralegal Service Level 2
Occupational Health and Safety Level 3
Industrial Security Level 2
Management Level 4
Microsoft Word
Microsoft Excel
Microsoft PowerPoint
QuickBooks
Typing
Course Payments & Initial Deposits (All payments are in United States Dollars (USD).
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next
( X )
General Office Administration Level 2
$
980.00
Quantity
1
2
3
4
5
6
7
8
9
10
General Office Administration Level 2 - Initial Deposit
$
352.00
Quantity
1
2
3
4
5
6
7
8
9
10
Business Administration Level 2
$
980.00
Quantity
1
2
3
4
5
6
7
8
9
10
Business Administration Level 2 - Initial Deposit
$
352.00
Quantity
1
2
3
4
5
6
7
8
9
10
Accounting Clerk Level 2
$
1,018.00
Quantity
1
2
3
4
5
6
7
8
9
10
Accounting Clerk Level 2 - Initial Deposit
$
333.00
Quantity
1
2
3
4
5
6
7
8
9
10
Customer Service Level 2
$
980.00
Quantity
1
2
3
4
5
6
7
8
9
10
Customer Service Level 2 - Initial Deposit
$
352.00
Quantity
1
2
3
4
5
6
7
8
9
10
Customs Services Level 2
$
980.00
Quantity
1
2
3
4
5
6
7
8
9
10
Customs Services Level 2 - Initial Deposit
$
352.00
Quantity
1
2
3
4
5
6
7
8
9
10
Paralegal Service Level 2
$
980.00
Quantity
1
2
3
4
5
6
7
8
9
10
Paralegal Service Level 2 - Initial Deposit
$
352.00
Quantity
1
2
3
4
5
6
7
8
9
10
Teacher Assistant Level 2
$
980.00
Quantity
1
2
3
4
5
6
7
8
9
10
Teacher Assistant Level 2 - Initial Deposit
$
352.00
Quantity
1
2
3
4
5
6
7
8
9
10
Accounting Level 3
$
1,097.00
Quantity
1
2
3
4
5
6
7
8
9
10
Accounting Level 3 - Initial Deposit
$
352.00
Quantity
1
2
3
4
5
6
7
8
9
10
Real Estate Level 3
$
1,097.00
Quantity
1
2
3
4
5
6
7
8
9
10
Real Estate Level 3 - Initial Deposit
$
352.00
Quantity
1
2
3
4
5
6
7
8
9
10
Payroll Administration Level 3
$
1,097.00
Quantity
1
2
3
4
5
6
7
8
9
10
Payroll Administration Level 3 - Initial Deposit
$
352.00
Quantity
1
2
3
4
5
6
7
8
9
10
Administrative Assistant Level 3
$
1,097.00
Quantity
1
2
3
4
5
6
7
8
9
10
Administrative Assistant Level 3 - Initial Deposit
$
352.00
Quantity
1
2
3
4
5
6
7
8
9
10
Human Resource Management Level 3
$
1,097.00
Quantity
1
2
3
4
5
6
7
8
9
10
Human Resource Management Level 3 - Initial Deposit
$
352.00
Quantity
1
2
3
4
5
6
7
8
9
10
Small Business Management Level 3
$
1,097.00
Quantity
1
2
3
4
5
6
7
8
9
10
Small Business Management Level 3 - Initial Deposit
$
352.00
Quantity
1
2
3
4
5
6
7
8
9
10
Supervisory Management Level 3
$
1,097.00
Quantity
1
2
3
4
5
6
7
8
9
10
Supervisory Management Level 3 - Initial Deposit
$
352.00
Quantity
1
2
3
4
5
6
7
8
9
10
Occupational Health & Safety Level 3
$
1,097.00
Quantity
1
2
3
4
5
6
7
8
9
10
Occupational Health & Safety Level 3 - Initial Deposit
$
352.00
Quantity
1
2
3
4
5
6
7
8
9
10
Marketing
$
1,097.00
Quantity
1
2
3
4
5
6
7
8
9
10
Marketing - Initial Deposit
$
352.00
Quantity
1
2
3
4
5
6
7
8
9
10
Executive Secretary Level 4
$
1,781.00
Quantity
1
2
3
4
5
6
7
8
9
10
Management Level 4
$
1,801.00
Quantity
1
2
3
4
5
6
7
8
9
10
1 Microsoft Office Course
$
137.00
Quantity
1
2
3
4
5
6
7
8
9
10
2 Microsoft Office Course
$
235.00
Quantity
1
2
3
4
5
6
7
8
9
10
QuickBooks
$
255.00
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Disclaimer: Additional fees are payable for every transaction conducted via this payment gateway.
Please tick as appropriate
Rows
Excellent
Good
Fair
Poor
Reading Skills
Writing Skills
Listening Skills
List Two References
1. Name of Referee
1. Referee's Address
1. Referee's Contact
2. Name of Referee
2. Referee's Address
2. Referee's Contact
Are You presently employed?
Yes
No
Please state employer
Employment History - List at least two last employers
1. Employer/Address
1. Employer's Phone
1. Position Held/Duration
2. Employer/Address
2. Employer's Phone
2. Position Held/Duration
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Reasons for terminating employment
1. Employment termination reason
2. Employment termination reason
3. Employment termination reason
Medical History
Do you have Allergies
Yes
No
Hypertension?
Yes
No
Asthma?
Yes
No
Diabetes?
Yes
No
Sinusitis?
Yes
No
Other medical condition
In case of emergency contact person
Please verify that you are human
*
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