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Section 1
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Sex MaleFemale
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Section 2
Name of Parent/Guardian/Sponsor
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In case of emergency contact
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Section 3 Educational History
CXC 'O' & 'A' Levels, Cape subjects passed/attempted to date (Each Subject on a new line)

Section 4
Duration of Course Sept-May/JuneSept-JanFeb-JanVacation
Course Times MorningAfternoonEveningSaturday

Section 5 Subjects Offered
C.X.C./C.S.E.C O' LEVEL Additional MathematicsChemistryEconomicsEnglish-AGeographyHuman and Social BiologyMathematicsPhysicsPrinciples of AccountsPrinciples of BusinessSocial StudiesSpanish
C.A.P.E A' LEVEL AccountingEconomicsEntrepreneurshipLawBusiness StudiesSociologyCaribbean StudiesCommunication Studies
Other desired subjects not offered at Elders' Classes

Section 6 Payment
C.X.C./C.S.E.C Number of Subjects and Cost
Example: 1 Subject = $2,400.00TTD, 2 Subjects = $4,800.00TTD, 3 Subjects = $7,200.00TTD ---2400.004800.007200.008800.009800.0010000.00
Cape A'Level Number of Subjects and Cost
Example: 1 Subject = $2,500.00TTD, 2 Subjects = $5,000.00TTD, 3 Subjects = $6,000.00TTD ---2500.005000.006000.00
G.P.F
Example C.X.C./C.S.E.C = $200.00, Cape A'Level = $300.00 200.00300.00
Total

Section 7
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Signature of Parent/Guardian/Sponsor