The University of the West Indies
St. Augustine Undergraduate Confirmation Receipt IMPORTANT NOTICE: Please Print, Sign and Submit this PAGE with Supporting Documents Name (PLEASE PRINT)):_________________________________ Web ID: ______________________________ Programme of 1st choice: _______________________________________________________________________ Programme of 2nd choice: _______________________________________________________________________ Programme of 3rd Choice: ______________________________________________________________________ Programme of 4th Choice: ______________________________________________________________________ DOCUMENTS SUBMITTED: The following documents are required. Please ensure that you submit these documents along with this signed page. Birth Certificate Marriage Certificate (where applicable) Legal Affidavit or Deed Poll if present name is different from that on the Birth Certificate Academic Certificates [GCE, CXC (CAPE), CXC (CSEC)]. GCE/CXC (CSEC/CAPE) Grade slips (accepted Only in cases where certificates are not yet available) Professional Certificate/Diploma Official transcripts [sent directly from granting Institutions; this does NOT apply to High/Secondary School students in Trinidad & Tobago] Autobiographical Statement (300 words) Mandatory for Faculty of Medical Sciences TOEFL Examination score (If English is not native language). TOEFL score of 500 or greater Supplemental Sheet 1[For Undergraduate applicants to BSc Nursing, BSc Human Ecology] Supplemental Sheet 2 Non-Academic Criteria for Selection to the Faculty of Medical Sciences Mandatory for [Link]. DDS & DVM Programmes ONLY Supplemental Sheet 3 Employee and Referee Information (Mature Applicants, Certificate and Diploma Applicants) Other (please specify)_____________________________________________________
DECLARATION I hereby certify that I have read and understood the instructions and the information necessary for completing this application and that all statements made are true and complete. I accept that the University reserves the right to reject this application if the information submitted in its support is based in whole or in part on deception or fraud.
______________________________________ Signature of Applicant
Outstanding Documents
______/______/___________ Date (dd/mm/yyyy)
FOR OFFICIAL USE ONLY
Birth Certificate Official Transcript Supplemental Sheet II Marriage Certificate CAPE Unit I Certificate GCE A-Level Certificate Supplemental Sheet I
CAPE Unit II Certificate CSEC/GCE O Level Certificate Autobiographical Statement Supplemental Sheet III
Detailed Work Experience History
Co-Curricular Form (FMS)
Other _________________________________________________
Documents Received By:
DATE:
STATUS:
Full-time
Part-time
Evening
OFFICIAL ASSESSMENT: Qualified Qualifying
D F A QA O OU AU QO
Other Qualifications Not Qualified Sponsored Contributing Non-Contributing
X U S NC
Re-Entry R
Refer for decision re Matriculation M Non Sponsored Contributing
NS
__________________________________ ___________ Signature of University Officer
________/_______/________ Date (dd/mm/yyyy)