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Re Admission Form

1) This document is an application for re-admission to COSTAATT, the College of Science, Technology and Applied Arts of Trinidad and Tobago. It collects personal information such as name, address, date of birth, contact details, program of study, and previous attendance records. 2) There are sections for applicants to disclose any disabilities and provide emergency contact information. Applicants must also declare that all information provided is accurate and complete. 3) The application will be reviewed by the relevant academic chair for a decision on re-admission and clearance from the registry office.

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Missy Samantha
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473 views2 pages

Re Admission Form

1) This document is an application for re-admission to COSTAATT, the College of Science, Technology and Applied Arts of Trinidad and Tobago. It collects personal information such as name, address, date of birth, contact details, program of study, and previous attendance records. 2) There are sections for applicants to disclose any disabilities and provide emergency contact information. Applicants must also declare that all information provided is accurate and complete. 3) The application will be reviewed by the relevant academic chair for a decision on re-admission and clearance from the registry office.

Uploaded by

Missy Samantha
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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APPLICATION FOR RE-

RE-ADMISSION

__________________________________________________________________________________________
______________________________________________________________________________________
Surname First Name Previous surname

Dr Mr Mrs Ms Miss

Address: ___________________________________________
___________________________________________________________________________
_______________________________________

__________________________________________________________________________
__________________________________________________________________________________________

Date of Birth ____/___/____ Student No. _____________


____________________ID or PP# _____________
______________________
DD MM YYYY

Tel: Home:______________Mobile:______
Mobile:____________ Work:____________ Email: _________________________
_______________________

PROGRAMME LEVEL:
LEVEL: Bachelor’s Degree Associate Degree Certificate Diploma Other

PROGRAMME NAME:
NAME ________________________________________________________________________
________________________________________________________

CAMPUS:
CAMPUS: POS Trincity South Tobago Sangre Grande

MODE: FULL-TIME PART-TIME

Desired Start Date:


Date September January Year _________ Day Evening

Citizenship: T & T Citizen Permanent Resident Caricom International

T&T Citizens: Have you been residing in TT&T for the past three (3) Years? Yes No

If NO, length of time in Trinidad: Years ______________ Months ________________


____

Diploma/Certificate from COSTAATT? Yes


Did you earn a Degree/Diploma/
Degree/Diploma/Certificate No

Previous dates of attendance at COSTAATT: From ___/_____/_____ To ___/___/_______


/_______

Previous COSTAATT Programme _______________________________________________________________

Please
lease list any institution(s) you have attended since leaving COSTAATT:

__________________________________________________________________________________________

____________________________________________________________________________
__________________________________________________________________________________________
2

DISABILITY DISCLOSURE:
DISCLOSURE:

Do you have a disability, chronic/long term medical condition or special need(s)? Yes No
If yes, please complete a Disability Disclosure Form. Please note that this information is required to assist
in assessing your requirements for educational provision.

NB: If you have not received a Disability Disclosure Form with this application, please contact the
Admissions Office.

EMERGENCY CONTACT:
CONTACT:
(Please complete ONLY if there has been a change since your last enrollment)

__________________________________________________________________________________________
Name Relationship Phone

__________________________________________________________________________________________
Address

DECLARATION OF APPLI
APPLICANT:
CANT:

I hereby certify that all information given on this application is accurate and complete. I understand that all
the information contained in this application will be treated confidentially and will be used for institutional
purposes only. I realize that failure to provide complete and accurate information may affect my re-
admission. I understand that my application will not be processed until all the necessary documents are
received by the Office of Admissions.

Applicant’s Signature _______________________________________ Date ____________________

FOR OFFICIAL USE ONLY

Academic Profile Reviewed by Chair. Decision:


Decision Approved for Readmission Not Approved

Comments:_________________________________________________________________________________

__________________________________________________________________________________________

Academic Chair’s Signature _____________________________________ Date ____________________

Registry Clearance Granted Yes No

Rev: 01/03/12

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