FORM A2

119 MAXFIELD AVENUE, KINGSTON 10 TEL. (876) 926-8912, 926-5328, 908-1997-8. FAX: 929-4178

SUMMER INTERNSHIP APPLICATION FORM

SURNAME: FIRST NAME: MIDDLE NAME:

GENDER: MALE FEMALE

DATE OF BIRTH: AGE:

CURRENT ADDRESS:

TRN: NIS#:
NEW APPLICANT
RETURNING APPLICANT

TA OFFICE:_____________________________________________________________________

SCHOOL / COLLEGE ATTENDING: GRADE/FORM

(CURRENT):

NAME OF MOTHER: NAME OF FATHER:

NAME OF GUARDIAN (IF APPLICABLE):

NAME OF RELATIVE EMPLOYED TO THE TRANSPORT

AUTHORITY:

EDUCATIONAL BACKGROUND

LIST OF SCHOOLS/COLLEGES ATTENDED STANDARD/RESULTS ATTAINED

a. …………………………………………………………………….. ……………………………………………………………….

b. …………………………………………………………………….. ……………………………………………………………….

c. …………………………………………………………………….. ……………………………………………………………….

d. …………………………………………………………………….. ……………………………………………………………….

FIELD OF INTEREST:

CAREER OBJECTIVE:

EXTRA CURRICULUM ACTIVITIES:

I CERTIFY THAT ALL ANSWERS GIVEN ABOVE ARE TRUE TO THE BEST OF MY
KNOWLEDGE. I UNDERSTAND THAT ANY FALSE DECLARATION IN THESE ANSWERS
WILL BE GROUNDS FOR IMMEDIATE DISMISSAL.

APPLICANTS NAME: _________________________________ SIGNATURE: ____________________

DATE:____________________ Date Received in Human Resource _______________________

 FOR HRM USE ONLY

COMMENTS

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Name: _____________________________________ Signature: __________________________

Position: ___________________________________________ Date: _____________________

Placement: ____________________________________________________________________

Duration of Placement: ____________________________________________________________