The Mico University College

Application for Admission to Undergraduate Programmes

Instructions

Please complete this form digitally using Adobe Reader (preferred) or List of Supporting Documents
Microsoft Edge Browser. Email completed form along with supporting - Birth Certificate - Transcripts (for applicants with
documents to apply@themico.edu.jm - Marriage Certificate / Deed Poll (if applicable) post-secondary certification)
- Picture Identification (Government or School ID) - Two (2) letters of recommendation:
- Passport-Sized Photograph of Student
Please upload a scanned copy or a clear cell phone picture of each supporting - Taxpayer Number (e.g TRN, SSN) Must be from any of these: JP,
Principal, Police above inspector
document. - Examination Certificates - (e.g CSEC, CAPE, etc.)
rank or Minister of Religion
- Diploma / Degree / Certificate (where applicable)

SECTION A – PERSONAL DATA IDENTIFICATION NUMBER (Leave blank) ……………………….

Title ( ) ………………………………………………………………………………………………………………
Last Name/Surname First Name Middle Name(s)

Maiden Name (if applicable)....................................................................... Sex:

Date of Birth........................ TRN/National I.D. .................................. Religious Affiliation ....................................................

(dd/mm/yyyy)

Marital Status

Permanent Address………………………………………………………………………………………………………………..

……………………………………. …………………………………………… ……………………………………....

Home Phone Number Cellular Phone Number Work Place Phone Number

Mailing Address (if different from above): ............................................................................................................................................

E-mail Address: ................................................................................................................................................................................

Country of Birth Country of Citizenship Country of Residence

................................................ ……………………………… …………………………………………

Next of Kin (NoK): ..........................................................................................................................................................

Last Name/Surname First Name Middle Name(s)

Relationship to Applicant............................................................…………………

Home/Permanent Address...............................................................................................................................................................

Home Phone Number........................... Cellular Phone Number.............................. Work Place Phone Number..............................

Fax....................................... E-mail Address.................................................................................................................

SECTION B – PROGRAMME DETAILS

To assist the applicant in completing this section, he/she is asked to note:
1. The Degree and Certificate programmes offered as well as the Faculty under which each programme falls are set out
in the ‘Undergraduate Programmes Listing’ which is attached to this form.
2. Applicants are reminded that although each programme is administered by a specific Faculty, the content of
programmes is often multi-Faculty, that is, the courses which constitute such programmes may be offered from two or
more Faculties.
3. Applicants may select Majors and Minors from two separate Faculties. However, it is to be noted that not all Majors
accommodate a Minor.

FIRST CHOICE FACULTY & PROGRAMME

SECOND CHOICE FACULTY & PROGRAMME

DESIRED YEAR OF ENTRY

PREFERRED TIME OF STUDY

SECTION C – EMERGENCY CONTACT (EC)
Title (Mr. / Miss/ Mrs.).....................................................................................................................................................................
Last Name/ Surname First Name Middle Name(s)

Relationship to Applicant..............................................................................

Home/Permanent Address...............................................................................................................................................................

Work Place Address.........................................................................................................................................................................

Contact’s Home Phone Number.................................................. Contact’s Cellular Phone Number....................................

Contact’s Work Place Phone Number................................. Ext. ......... Fax. ..................................................................

SECTION D – GENERAL INFORMATION

Have you previously studied at The Mico College/ University College or any other Teachers’ College or University?
Yes No If yes, please complete the following:
Name of Institution................................................................................... Identification (I.D.) Number..................................
(If you previously attended The Mico)

Registered From: ......................... To: ........................... Programme...............................................................................

Do you have a disability or special needs? Yes No

If yes, please specify (This information is needed in case special facilities are required)
............................................................................................................................................................................................................

Do you wish to live in a Hall of Residence? Yes No

If yes, please also complete and return the boarding form provided.

How did you obtain information about The Mico? School/College Fair School visit Internet

Media Other (Please specify).............................................................................................................................................

SECTION E – SECONDARY EDUCATION INFORMATION

List the name(s) of the high school(s)/ secondary institution(s) attended (if not in Jamaica, please state country):

a)....................................................................................................................... From............................. To....................................

b)....................................................................................................................... From............................. To....................................

c)....................................................................................................................... From............................. To....................................

d)....................................................................................................................... From............................. To....................................

SECTION F – ACADEMIC ACHIEVEMENT RECORD

List all subjects at CXC (CSEC) General Proficiency and/or GCE Ordinary Level.
Examination Body e.g. Results Date of Examination
CXC, Cambridge, London, AEB Subjects (Grade) (dd/mm/yyyy)

List all subjects at CXC (CAPE) Unit 1 & Unit 2 and GCE Advanced Subsidiary and/or Advanced Level.
Date of Examination
Examination Body Subjects Results(Grade) (dd/mm/yyyy)
List academic programmes or examinations for which you are currently preparing or awaiting results.

Level
Examination Body e.g. CSEC, Cape or GCE Subject/ Programme Date of Exam
‘O’ and/ or ‘A’ Level (dd/mm/yyyy)

List any post-secondary institution(s) you have attended, the courses and/or programmes (including degrees) you completed
and which you wish to be used to satisfy Matriculation requirements.

Type of Studies Certification

Name of Institution From To Subject e.g. Course(s) or e.g. Certificate, Date
(dd/mm/yyyy (dd/mm/yyyy) Area/Major Full Programme Diploma or Degree Awarded
)

CO-CURRICULAR INFORMATION
List any sporting/cultural activities/service clubs in which you have played an active role.

............................................................................................................................................................................................................
............................................................................................................................................................................................................
............................................................................................................................................................................................................

Do you play any musical instrument(s)?

a) Yes No b) If yes, please specify..................................................................................................................

SECTION G – FINANCIAL RESOURCE INFORMATION

Expected Source(s) of Funding:
Government S.L.B Loan Self JAMVAT
Parent(s) Award N.Y.S. Other

Are you a Mico Staff Member? Yes No Are you a dependent of a Mico Staff Member? Yes No
If yes, please state: If yes, please state:
Staff Identification Number............................. Name of Staff Member....................................................................

Department........................................................ Department......................................................................................

Relationship to Applicant...............................................................
SECTION H – EMPLOYMENT RECORD
List employment information starting with current (if not currently employed, list most recent) job.

a) Name of employer....................................................... b) Name of employer..............................................................

Job classification......................................................... Job classification.................................................................
Address........................................................................ Address...............................................................................
Town or Village/City & Street/P.O. Box Town or Village/City & Street/P.O. Box

Telephone Number.......................... Fax. .......................... Telephone Number............................. Fax. ..................................

Parish................................................................................. Parish............................................................................................

Country.............................................................................. Country........................................................................................

From................................ To........................................... From........................................ To..............................................

SECTION I – REFEREE INFORMATION

Name Two Referees:

a) Name of Referee............................................................. b) Name of Referee...............................................................

Name of Organization.................................................... Name of Organization.......................................................

Position Held.................................................................. Position Held.....................................................................

Address.......................................................................... Address............................................................................
Town or Village/City/Street/P.O Box Town or Village/City/Street/P.O Box

Telephone Number......................................................... Telephone Number...........................................................

Parish/Country............................................................... Parish/Country..................................................................

City/Town/Post Office...................................................... City/Town/Post Office.......................................................

SECTION J – DECLARATION
I hereby certify that I have read and understood the instructions This application is made with my consent and I
and the information necessary for completing this application and intend to provide such fees as may be payable to
that all statements made are, to the best of my knowledge, true and The Mico.
complete. I intend to provide such fees as may be payable to
The Mico. I understand that otherwise my admission to or
registration at the institution may be revoked.

....................................................................../............................... ............................................................./.......................
Signature of Applicant Date (dd / mm / yyyy) Signature of Parent/Guardian/ Date (dd/ mm / yyyy)
(Please type your full name) Financial Benefactor (where applicable)
(Please type their full name)

FOR OFFICIAL USE ONLY

Documents/Items Received Original Documents Returned

Application Fee Receipt No. ................................

Birth Certificate
Marriage Certificate
Deed Poll
Transcripts ......................................................................................
CXC/GCE Certificates Signature of Admissions Officer Date (dd/mm/yyyy)
Teachers’ Certificate/ Diploma
Other (specify)....................................................................
......................................................................................
University Registrar Date (dd/mm/yyyy)

NOTE: ALL SECTIONS OF THIS FORM MUST BE COMPLETED IF APPLICABLE. FOR SECTION(S) NOT APPLICABLE, PLEASE
WRITE “NA”. ALL APPLICATIONS MUST BE ACCOMPANIED BY A COPY OF ACADEMIC AND BIRTH CERTIFICATES.