Application Form Pomtech

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PORT P.O.

BOX 1969 PORT MORESBY, NCD,


PAPUA NEW GUINEA
MORESBY Tel. No.: 321- 4311
Fax No.: 321 – 1057
TECHNICAL E-mail: pomtech@ymail.com
COLLEGE Http://portmoresbytechnicalcollege.blogspot.com

STUDENT’S APPLICATION FORM


A. PLEASE PUT A TICK ON THE COURSE YOU ARE APPLYING FOR:
(PLEASE READ CAREFULLY.
ONLY TICK ONE CERTIFICATE COURSE AND NAME OF TRADE COURSE.
PRINT CLEARLY IN BLOCK LETTERS.) Paste 1½ x 1 ½
STUDENT’S
IMPORTANT: YOU CAN NOT CHANGE YOUR COURSE ONCE YOU ARE PHOTO
ALREADY ENROLLED WITH THE COURSE YOU HAVE SELECTED.
here
B. TYPE OF CERTIFICATE COURSE:

NATIONAL CERTIFICATE 1 (NC1) CAREER EDGE PROGRAM


NATIONAL CERTIFICATE 2 (NC2) IT CERTIFICATE IN:-
BASIC TRADE CERTIFICATE (BTC) HARDWARE AND NETWORKING
WEB DESIGN AND DEVELOPMENT
JAVA PROGRAMMING
C. NAME OF TRADE COURSE:

MOTOR VEHICLE MECHANICS (MVM) MAINTENANCE FITTING & MACHINING (MFM)


METAL FABRICATION & WELDING (MFW) AUTO ELECTRICAL (AE)
PRINTING / GRAPHIC ARTS ELECTRICAL
CARPENTRY CONSTRUCTION ELECTRONICS
AUTO BODY REPAIR & FINISHING REFRIGERATION

D. STUDENT DETAILS

LAST NAME: ……………………………………………………. FIRST NAME: ……………………………………….

SEX / GENDER: MALE FEMALE DATE OF BIRTH: …………………………………..

HOME VILLAGE: ………………………………………………. PROVINCE: ………………………………………….

NEAREST AIRPORT: …………………………………………. RELIGION: …………………………………………..

HOME ADDRESS: ………………………………………………………………………………………………………………

PHONE NUMBER: …………………………………………….. FAX NUMBER: ……………………………………..

E. PARENT OR GUARDIANSHIP DETAILS


NAME: ……………………………………………………………………………………………………………………………

ADDRESS:……………………………………………………………………………………………………………………….

PHONE NUMBER: ……………………………………………. FAX NUMBER: ……………………………………..

F. WHO WILL BE PAYING FOR YOUR SCHOOL FEES? (PLEASE TICK ONE).
SELF SPONSORED COMPANY SPONSORED
Application “KNOWLEDGE AND SKILLS DEVELOPMENT FOR EMPLOYMENT OPPORTUNITIES”
Form
G. PLEASE TICK THE STATUS YOU PREFERRED:
BOARDING & LUNCH DAY WITH LUNCH DAY WITHOUT LUNCH
Not available as of this time

H. ACADEMIC DETAILS: (Indicate marks/grades on the spaces provided)


PRIMARY SCHOOL: ……………………………………………….. HIGH SCHOOL: ……………………………………..

ENGLISH MATHS SCIENCE S/SCIENCE

GRADE 10 ............... …………… ………….. ……………

GRADE 12 ............... …………… ………….. ……………

LAST YEAR ATTENDED HIGH SCHOOL: ………………………………………………………………………………….

I. FOR NC1 GRADUATES, ATTACHED PHOTOCOPY OF YOUR NC1 CERTIFICATE.

J. ALL APPLICATIONS RECEIVED WITHOUT DOCUMENTARY EVIDENCE WILL BE DISREGARDED.

K. Attached photocopy of the NON REFUNDABLE application/processing fee receipt of K20.00. Non-
compliance of this, your application WILL NOT be entertained by the selection committee. Payment
can be made by depositing the fee into the college account:

Account Name : Port Moresby Technical College


Account Number: 401 649 802
Bank :
Branch : Port Moresby (or in any branch)

L. SPONSOR’S DETAILS:
COMPANY NAME: ………………………………………………….. CONTACT PERSON: ………………………………

ADDRESS: …………………………………………………………… PHONE NUMBER: ………………………………….

IMPORTANT: WE DO NOT ENTERTAIN FAXED OR EMAILED APPLICATION FORMS, SUBMIT IT


PERSONALLY OR THROUGH POST MAIL.

CONTRACT

AS A STUDENT I AM BOUND BY THE RULES AND REGULATIONS OF THE COLLEGE AND/OR THE
APPRENTICESHIP BOARD. (“LIVE AND LET OTHERS LIVE” IS THE PRINCIPLE THAT BINDS THE
COLLEGE COMMUNITY TOGETHER.) AS A NEW MEMBER OF THE COLLEGE COMMUNITY I AM
BOUND TO LIVE UP TO THIS PRINCIPLE, AND CONDUCT MYSELF WITH DIGNITY AND DISCIPLINE
THROUGHOUT THE COURSE OF MY STUDIES AT THE COLLEGE. I UNDERSTOOD THAT THE
STUDENT’S NAME ON THIS FORM WILL BE THE SAME NAME THAT WILL APPEAR ON MY
CERTIFICATE ONCE I COMPLETED THE COURSE.

SIGNED: …………………………………………………………….. DATE: ……………………………………….


STUDENT

DP Academic’s Office copy

Application “KNOWLEDGE AND SKILLS DEVELOPMENT FOR EMPLOYMENT OPPORTUNITIES”


Form

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