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Marcus Garvey Technical High School

P.O. Box 159, St. Ann’s Bay

REGISTRATION FORM

Please complete this form by writing the information in the spaces provided.

Please place a tick where the option(s) are given.

Student’s Information
FIRST NAME: Click or tap here to enter text.	MIDDLE NAME: Click or tap here to enter text.	LAST NAME: Click or tap here to enter text.
ADDRESS: Click or tap here to enter text.
LAST SCHOOL ATTENDED: Click or tap here to enter text.	LAST GRADE REACHED:Choose an item.	DATE OF BIRTH: Click or tap to enter a date.	BIRTH CERTIFICATE REGISTRATION No.: Click or tap here to enter text.
NAME OF CHURCH ATTENDING: Click or tap here to enter text.	GAMES YOU PLAY WELL: Choose an item.	WHICH CAREER FIELD DO YOU WISH TO PURSUE? Click or tap here to enter text.
EXAMINATION PASSED:	☐	P.E.P.	☐	G.S.A.T.	☐	G.N.A.T.	☐	TRANSFER	YEAR: Choose an item.
MOTHER’S INFORMATION
FIRST NAME: Click or tap here to enter text.	LAST NAME: Click or tap here to enter text.	ADDRESS: Click or tap here to enter text.
CONTACT NUMBER: Click or tap here to enter text.	OCCUPATION: Click or tap here to enter text.	NAME OF EMPLOYER: Click or tap here to enter text.	EMPLOYER’S NUMBER: Click or tap here to enter text.
FATHER’S INFORMATION
FIRST NAME: Click or tap here to enter text.	LAST NAME: Click or tap here to enter text.	ADDRESS: Click or tap here to enter text.
CONTACT NUMBER: Click or tap here to enter text.	OCCUPATION: Click or tap here to enter text.	NAME OF EMPLOYER: Click or tap here to enter text.	EMPLOYER’S NUMBER: Click or tap here to enter text.
GUARDIAN’S INFORMATION
FIRST NAME: Click or tap here to enter text.	LAST NAME: Click or tap here to enter text.	ADDRESS: Click or tap here to enter text.
CONTACT NUMBER: Click or tap here to enter text.	OCCUPATION: Click or tap here to enter text.	NAME OF EMPLOYER: Click or tap here to enter text.	EMPLOYER’S NUMBER: Click or tap here to enter text.
AUTHORIZED CONTACTS: The names of the following three (3) persons are the only ones who have permission to visit/represent/do business on behalf in my absence/unavailability concerning my child/ward.
NAME : Click or tap here to enter text. ADDRESS : Click or tap here to enter text. RELATION : Click or tap here to enter text. TELEPHONE : Click or tap here to enter text.
NAME : Click or tap here to enter text. ADDRESS : Click or tap here to enter text. RELATION : Click or tap here to enter text. TELEPHONE : Click or tap here to enter text.
NAME : Click or tap here to enter text. ADDRESS : Click or tap here to enter text. RELATION : Click or tap here to enter text. TELEPHONE : Click or tap here to enter text.
PARENT DECLARATION
I click or tap here to add parent/guardian’s name endorse this application to see to it that my child/ward abides by the rules and regulations of the Marcus Garvey Technical High School. I also give/do not give permission for pictures and/or videos be used on the Marcus Garvey Technical High School Social Media Pages. Signature of Parent/Guardian:Click or tap here to enter text. Signature of Student:Click or tap here to enter text. Date:Click or tap to enter a date.
OFFICIAL USE ONLY
REGISTRATION AGENT:	REGISTRATION AGENT’S SIGNATURE:	DATE:
PRINCIPAL:	PRINCIPAL’S SIGNATURE:	DATE: