SectionA-Applicant details
ProgrammeApplication Form
Macedonia School of Nursing & More
17A Fletchers Avenue, Linstead, St Catherine, Jamaica
Tel: 876-705-6696 or 876-855-6138
Email:
macedoniaschoolofnursing@gmail.com
Please read carefully before signing this form.
Title
Mr.
Mrs.
Miss.
Ms.
Dr.
Other
Name
First Name
Middle Initial
Last Name
Gender
Male
Female
Date of birth
-
Month
-
Day
Year
Date
TRN
Marital Status
Single
Married
Divorced
Widowed
SectionB-Address Details
Current residential address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
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Country
Telephone number mobile
Work
Email
example@example.com
N.O.K:
Relationship:
Tel:
School education
School attended (Give full name)
School attended (Give full name)
Subject name
Subject name
Level- (CSECs/CXC/CAPE/NC TVET)
Grade
Year achieved
1
2
3
4
5
6
7
8
9
10
11
12
Tick the program you are interested in applying to
Practical Nursing L2
Practical Nursing L3
Phlebotomy
Geriatric Ns
E.C.E L2
E.C.E L3
Pediatric
Customer Ser.
Computer
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TELLUSABOUTYOURSELF
Your Skills: eg. Cashiering
Choice of study:
Online (5pm to 6:30pm and 7pm to 8pm)
Onsite(Face to face)
Saturdays 12pm to4pm
-Weekdays
Morning 8:45 am to 1:45pm
Afternoon 3pm to 5pm
Evening 5pm to 6: 30pm
Any known disabilities (medically, physically & mentally)?
Other
How did you learn about us, through which of the followings?
Advertisements
Friends
Flyers
Posters
nternet
Website
Do you like the environment?
Yes
No
Do you have any payment plans?
Yes
No
Would you introduce the school to others?
Yes
No
Any criminal records?:
Yes
No
References
References (use only one family member)
Name
Name
address
Telephone number
Position/ Relation
1
2
3
4
Programmes TuitionFees
ProgrammesTuitionFees
Tuitionfee($-JMD)
3months
6months
12 months
24months
24months
24months
1. Practical Nursing/Patient Care Assistance L2
2. Practical Nursing/Patient Care Assistance Level 3
3. Early Childhood Education L2
4. Early Childhood Education L3
5. Phlebotomy
6. Pediatric Nursing
7. Geriatric Nursing L2
8. Basic Computing
9. Customer Service
All these fees does not include examinations (main or resit), certificate, practical sessions and exams, etc.
Please see the following information for payment:
Payment can be made at any Jamaica National Bank, through our website, PayPal, online banking, direct transfer, Dropbox or a Cheque.
Banking information
Bank:
Jamaica National Bank
Account Name/Holder:
Macedonia School of Nursing and More
Type:
Business/ Savings (institution)
Account Number:
2094273518
There is no refund to any tuition fee paid for any of our programme students are only allowed to transfer their fee to do another programme.
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Is there any other information that we need to know that was not stated above?
SIGNATURE
Applicant signature:
Date:
-
Month
-
Day
Year
Date
OFFICIALUSEONLY
OFFICIALUSEONLY Please assess applicant by a tick () of one of the following below
Assessment
Excellent
Good
Satisfactory
Poor
1
2
3
4
5
6
Signature
Date
-
Month
-
Day
Year
Date
Please see the following information for payment:
Payment can be made at any Jamaica National Bank, through our website, PayPal, online banking, direct transfer, Dropbox or a Cheque.
Banking information
Bank:
Jamaica National Bank
Account Name/Holder:
Macedonia School of Nursing and More
Type:
Business/ Savings (institution)
Account Number:
2094273518
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