Application Form

THE UNIVERSITY OF THE WEST INDIES
ST. AUGUSTINE, TRINIDAD AND TOBAGO, WEST INDIES
TELEPHONE: (1-868) 662-2002 ext. 83064 EMAIL: pgonline@sta.uwi.edu

SECTION A - PERSONAL DATA

1. a) First Name

1. b) Middle Name

1. c) Last Name

2. Have you previously applied to The UWI?

Yes

3. National ID/Drivers Permit/Passport Number

4. Have you previously been a student at The UWI?

Yes

5. a) UWI ID Number

5. b) Campus

6. a) Gender

6. b) Date of Birth

6. c) Marital Status

7. a) Country of Birth

7. b) Country of Citizenship

7. c) Country of Residence

8. a) Are you differently abled?

NoYes

8. b) Do you require any special accommodations? Please Specify:

MAILING ADDRESS & CONTACT INFORMATION

9. a) Apt/Street #/PO Box

9. b) City/Town/Post Office

9. c) Parish/County

9. d) State

9. e) Zip/Postal Code

9. f) Country

10. a) Email Address

10. b) Contact Number 1

10. c) Contact Number 2

EMERGENCY CONTACT INFORMATION

11. a) First Name

11. b) Last Name

11. c) Contact Number

SECTION B - FACULTY & COURSES

12. Please select the course you wish to take at The UWI:

13. a) Are you a UWI Staff Member?

NoYes

14. a) Are you a dependent of a UWI Staff Member?

NoYes

13. b) Staff ID Number

14. a) Name of Staff Member

14. c) Relationship to Staff Member

13. c) Campus

14. d) Campus

13. d) Department

14. f) Department

SECTION C - ACADEMIC/EMPLOYMENT RECORD

15. Academic Qualifications
Academic Institution and Address	Type of Programme(Cert/BSc etc)	Subject Area	Date of Award	Class of Degree/GPA

Add Row

16. Employment Record relevant to course admission criteria
Employer Name & Address	Period of Employment	Duties and Responsibilities

Add Row

SECTION D - Document Upload

Birth Certificate (non UWI Students only, PDF)

CV (PDF)

Reference from Employer/Referee (PDF)

SECTION A - PERSONAL DATA

BIO DATA

MAILING ADDRESS & CONTACT INFORMATION

EMERGENCY CONTACT INFORMATION

SECTION B - FACULTY & COURSES

SECTION C - ACADEMIC/EMPLOYMENT RECORD

SECTION D - Document Upload