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
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
Telephone number mobile
Format: (000) 000-0000.
Work
Email
example@example.com
N.O.K:
Relationship:
Tel:
School education
Rows
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
Back
Next
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)
Rows
Name
Name
address
Telephone number
Position/ Relation
1
2
3
4
Programmes TuitionFees
ProgrammesTuitionFees
Rows
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.
Back
Next
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
Rows
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
Preview PDF
Submit
Should be Empty: