MINISTRY OF EDUCATION / GHANA EDUCATION SERVICE

GHANA TVET SERVICE Quick Enrolment Code

COMPUTERISED SCHOOL SELECTION & PLACEMENT SYSTEM

(CSSPS)
ENROLMENT FORM

Application for Entry into Senior High Schools (SHS)/Technical & Vocational Institutes (TVI)
To be submitted to Head of Senior High School or Technical & Vocational Institute placed
(Any erasure renders this form invalid.) - 2023

INDEX NUMBER: 030701403723

TOTAL RAW SCORE (Four Core Subjects): 216
AGGREGATE: 24

SHS/TVI PLACED: Potsin T.I. Ahm. Senior High

PROGRAMME: GENERAL ARTS

Enrolment Code: 7S2AXN

SECTION A: PERSONAL DETAILS OF CANDIDATE

(To be completed by candidate)

Name: ESHUN BENEDICTA

Date of Birth: (DD/MM/YY) Place of Birth: Gender: Female

JHS Attended: ASIKUMA CATHOLIC GIRLS JHS

Town:

District: ASIKUMA ODOBEN BRAKWA

Region: CENTRAL

Permanent Address:

Signature of Candidate:

SECTION B: PARTICULARS OF PARENTS/GUARDIANS

Name of Father:

Occupation:

Name of Mother:

Occupation:
 Name of Guardian:

Postal Address:

Residential Address:

Residential Telephone:

Other Telephone:

Signature of Parent/Guardian:

Date (DD/MM/YYYY):
SECTION C: TO BE COMPLETED BY STUDENT
Indicate your interest:

(a) Athletics [ ]

Football [ ]

Debating Club [ ]

Others [ ]

(b) School Awards:

(c) Position Held:

(d) I, ESHUN BENEDICTA do accept that my admission into this school opens a new chapter in my life. i therefore pledge to
abide by all the rules and regulations of the school

Candidate Witness (Headteacher, Pastor, Snr. Public/Civil Servant,

Lawyer)

Name: Name:
ESHUN BENEDICTA

Signature: Signature:

Date (DD/MM/YYYY): Date (DD/MM/YYYY):

SECTION D:
(FOR PLACEMENT ONLY)

Name of Head of SHS/TVI:

Signature:

Date/Stamp:

Students Identity No. (If Any):