Marian Academy — Sixth Form Application

Tell us about the applicant. Fields marked * are required.

Surname *

Other names *

Gender

Male Female Other

Contact number

Email

Home address

Date of birth

Age

Country of birth

Nationality

Religion

Place (Church)

Date of baptism

Church address

Previous school

Year completed Form 5

List the subjects you wrote. You can attach the official results slip in the Documents step.

SubjectGradeYear

Number of Grade I–III passes

Pending / resit subjects

Which programme are you applying for?

Stream

ScienceBusinessArts/General

Year of entry

Other subject(s)

Intended career / field of study

Any existing links to Marian Academy? (optional)

Sibling(s) attending / attended Marian Academy

Present class

Year graduated

Is a parent a past pupil of the school?

Yes No

If yes, who

Year graduated

House parent(s) were in

Referred by

Parent and guardian contact details.

Father

Surname

Other names

Address

Telephone

Occupation

Place of work

Work telephone

Nationality

Email

Mother

Surname

Other names

Address

Telephone

Occupation

Place of work

Work telephone

Nationality

Email

Guardian

Surname

Other names

Address

Telephone

Occupation

Relationship to student

Nationality

Email / work tel.

Medical and emergency information.

Name of doctor

Doctor's telephone

Permission to call your doctor / St. Joseph's Mercy Hospital in an emergency?

Yes No

Emergency contact (if neither parent can be reached)

Name

Address

Tel. (Home)

Tel. (Work)

Tel. (Cell)

Allergies or chronic illness?

Yes No

If yes, please specify

Any physical disabilities?

Yes No

If yes, please specify

Other health information the school should have

Upload scans or photos of your supporting documents — birth certificate, immunization card, CSEC/CXC results slip, two passport photos, previous school report, and baptismal certificate.

Tap to upload or drag files here

PDF, JPG or PNG · up to 10 MB each

Please read and confirm before submitting.

I agree to abide by all the regulations of the school. I undertake to pay the School fees by the first week of each term, and I understand that a term's notice (or a term's fee in lieu of notice) is required before withdrawal.

I confirm that the CSEC results and other information given above are true and complete, and I understand that admission to the Sixth Form is conditional on verification of these results.

Date of application

Signature of applicant (type full name)

Signature of parent / guardian (type full name)