CTC Rev.

2008

DIOCESE OF JAMAICA & THE CAYMAN ISLANDS

CHURCH TEACHERS COLLEGE: MANDEVILLE

APPLICATION FORM
(To be completed and returned to the College)

PERSONAL INFORMATION
SURNAME: ___________________________________________
(PLEASE USE BLOCK LETTERS)

CHRISTIAN NAME: _____________________________

MIDDLE NAME: ________________________________
MAIDEN NAME: ________________________________
GENDER:

Male

Female

PHOTO
Please paste a passport
size picture here
Place the other in an
envelope and submit
with Application Form

MARITAL STATUS: _____________________________

DATE OF BIRTH: _______________________________
NATIONALITY: _________________________________
HOME ADDRESS
Street/District: ___________________________________________________________
City/Parish:______________________________________________________________
Country: _____________________ Email Address: ______________________________
Contact Nos.:: Mobile________________ Home:____________ Work:____________
POSTAL ADDRESS (if different from Home address)
Street/District: __________________________________________________________
City/Parish: ____________________________________________________________
Country: _____________________
EMERGENCY CONTACT
Name: ______________________________ Relation to you:___________________
Address: ______________________________________________________________
Contact Nos: Home: __________________

Mobile: ________________________

REVISED

CTC Rev. 2008

PROGRAMME CHOICE
Please tick the Diploma Programme that you wish to pursue:
EARLY CHILDHOOD (Fulltime)

EARLY CHILDHOOD (Part-time)

SECONDARY EDUCATION

SPANISH (Primary)

If you select the Secondary Education Programme, state, in order of preference, the Subject
Options you wish to pursue. (See Page 7):
1. _______________________________________________________

2. _______________________________________________
If given the opportunity to upgrade to degree status, would you be interested? Yes No

EDUCATION
INSTITUTIONS ATTENDED
School Name / Type

Street or
District

City or
Parish

Country

Date
From

Date
To

REVISED

CTC Rev. 2008

QUALIFICATIONS (Subjects passed and Certificates awarded)

Status
(obtained/pending)

Examining
Body

Subject Area

Grades

Date

ACTIVITIES
Offices held: ___________________________________________________________________
Games played: _________________________________________________________________
Hobbies: ______________________________________________________________________
Clubs: ________________________________________________________________________
Responsibilities/duties: __________________________________________________________
_____________________________________________________________________________
Do you play a musical instrument?

Yes

No

If yes, please state: _____________________________________________

3

REVISED

CTC Rev. 2008

REFERENCES

Please give three (3) character &/or job references

1. NAME: __________________________________________________________________
ADDRESS:________________________________________________________________
PHONE NO: _____________________________
2. NAME: __________________________________________________________________
ADDRESS: _______________________________________________________________
PHONE NO: _____________________________
3. NAME: __________________________________________________________________
ADDRESS: _______________________________________________________________
PHONE NO: _____________________________

FINANCIAL INFORMATION
Indicate how you will finance the programme for a three year period: _____________________
___________________________________________________________________
___________________________________________________________________

JOB HISTORY
Have you ever had any teaching experience? Yes No
If Yes, state total years of teaching experience ____________
If you have left school, have you been working since leaving? Yes No
If Yes, please list your employment in the Table below:

REVISED

CTC Rev. 2008

JOB HISTORY TABLE

Employer/Position

Street/
District

Parish/city

Country

From

To

If no, what have you been doing?

___________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

COLLEGE
COLLEGE PREFERENCES: Choice 1: ______________________________________________
Choice 2: ______________________________________________
Choice 3: ______________________________________________
5

REVISED

CTC Rev. 2008

Would you accept an offer from another College?

Do you need accommodation on Campus? Yes

Yes

No

No

List two (2) Persons you can stay with if accommodation on Campus is not offered:
1. Name: __________________________________________________________________
Address: ________________________________________________________________
Phone no: _______________
2. Name: __________________________________________________________________
Address: ________________________________________________________________
Phone no: _______________
Are you willing to comply with the Colleges
Dress code?

Yes

No

Deportment regulations?

Yes

No

General rules & regulations? Yes

No

CONFIDENTIAL
Parents Name:________________________________________________________________
Parents Address:______________________________________________________________
Parents Contact Nos:__________(Cell) ____________(Home) _____________ (Work)
Spouses Name (if applicable)____________________________________________________
Spouses Address (if applicable):__________________________________________________
Spouses Contact Nos. (if applicable): ___________ (Cell) ____________ (Work)
Religious Affiliation/Denomination:________________________________________________
Does your religion prevent participation in any of the following activities?
Physical Education:

Yes

No

Music and Movement: Yes

No

Chapel Service:

Yes

No

Daily College Worship: Yes

No

Christmas Lunch:

Yes

No

Graduation:

No

Yes

If YES, please explain:__________________________________________________________

____________________________________________________________________________
6

REVISED

CTC Rev. 2008

CHURCH TEACHERS' COLLEGE: MANDEVILLE

Secondary Education
SUBJECT OPTIONS OFFERED 2008
Students must have a CXC (or equivalent) Grade 1 or 2 in the subject area.
Double Option Programmes
English (Language and Literature)
Science (Chemistry, Physics or Biology- choose any two)
Human Ecology (Home Economics)
Mathematics

Single Option Programmes

Students MUST pursue subjects in ONE of the following combinations:

Religious Education and History

Religious Education and Mathematics
Religious Education and Social Studies
Religious Education and Geography
Religious Education and Computer Studies
Science and History
Science and Mathematics
Science and Geography
Science and Computer Studies
Physical Education and Mathematics
Physical Education and Science
Physical Education and History
Computer Studies and History
Computer Studies and Social Studies
Computer Studies and Mathematics
History and Geography
Geography and Social Studies
Geography and Mathematics