Caribbean Examinations Council (CXC) – CSEC Examinations – January 2014
... Biology. Chemistry. Human & Social Biology. N/A. N/A. Physics. Mathematics.
2A Piccadilly Road, Kingston 5 (entrance on Manhattan Road) Tel: 926 6573(LIME) / 618-3721(Digicel), Fax:926-8110 Email:
[email protected] Website: www.overseasexams.org.jm
Caribbean Examinations Council (CXC) – CSEC Examinations – January 2014 ENTRY FORM FOR PRIVATE CANDIDATES PLEASE WRITE IN BLOCK CAPITALS (AS WRITTEN HERE) Candidate Details: 1. First Name:
_________________________________________________________________________
Middle Name: _________________________________________________________________________ Last Name:
_________________________________________________________________________
2. Date of Birth: ________ /________ /_________ 3. Gender: (Please tick √): Male ( DD / MM / YYYY
)
Female (
)
4. Mailing Address (line 1): ________________________________________________________________ (line 2): ________________________________________________________________ 5. Parish: _____________________________________ 6. Previous Registration No.: 100______________ 7. E-Mail Address::________________________________________________________________________ (e.g.
[email protected])
8. Tel. Number (Work) : ________-____________ Tel. Number (Home) : ________-____________
(Cell #) ______ - _____________ (Lime) (Cell #) ______ - _____________ (Digicel)
9. SUBJECTS TO BE ENTERED:
Indicate by a tick (√) the subject(s) for which you wish to be entered. Please ensure that you complete each column. Do not enter any subject(s) other than those listed in the Table below. Subjects (Choose the subject required) ARTS English B (Literature)
Tick (√)
RESIT Carrying forward Previous SBA Score(√)
ALT. (Paper 3/2) No SBA Score
(√)
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
st
1 First time sitting subject
Repeat
(√)
(√)
Doing over Subject
SelfTutored Studying on Own
(√)
School Attending School/ Private Classes
(√)
BUSINESS Office Administration Principles of Accounts Principles of Business Social Studies LANGUAGES English A (Language) Spanish* SCIENCES** Biology Chemistry Human & Social Biology Physics Mathematics Information Technology Total No. of Subjects Entered (i) *Spanish: Candidates entering for CXC Spanish MUST be prepared to sit their Oral Examination as well as Papers 1 and 2 in Kingston. (ii) **Sciences/Information Technology: Please note Only SBA Grades for CXC May/June 2013 may be used to Resit the Subject. P.T.O→
10. Examination Fees to be Paid: NOTE: 1. Calculations for the number of subjects and fees have already been done to
assist you in your payment. 2. Select the number of subjects for your entry and pay the applicable fee listed in the Table below.
EXAMINATION FEE STRUCTURE NB: Candidates registering for SPANISH should ADD the Oral Fee to get the Total Amount Due Fee Structure:
One (1) Subject
Two (2) Subjects
Three (3) Subjects
Four (4) Subjects
Five (5) Subjects
Six (6) Subjects
Entry Fee
$3,585.00
$3,585.00
$3,585.00
$3,585.00
$3,585.00
$3,585.00
Subject Fee(s)
$2,280.00
$4,560.00
$6,840.00
$9,120.00
$11,400.00
$13,680.00
Sub-Total
$5,865.00
$8,145.00
$10,425.00
$12,705.00
$14,985.00
$17,265.00
Spanish Oral Fee ($865.00) ***If Applicable TOTAL AMOUNT DUE Indicate your choice with a tick (√) NOTE: Fees are subject to review in accordance with changes in the rate of Foreign Exchange _________________________________________________________________________________________ 11. Examination
Centre Preferred Location:
Select (tick √) the location most convenient for you to sit your examinations.
(
)
Kingston & St. Andrew
(
)
Montego Bay, St. James
(
)
Portmore, St, Catherine
(
)
Brown’s Town, St. Ann
(
)
Spanish Town, St. Catherine
(
)
Port Maria, St. Mary
(
)
May Pen, Clarendon
(
)
Port Antonio, Portland
(
)
Mandeville, Manchester
(
)
Morant Bay, St. Thomas
(
)
Savanna-La-Mar, Westmoreland
(
)
Santa Cruz, St., Elizabeth
NB: The availability of a Centre in the area specified is dependent upon the number of candidates requesting that Centre. Candidates will be informed of any changes using their e-mail address or telephone number provided.
Signature: _____________________________________________ Date:____________________________
Important Note: The completed application form, and payment voucher MUST be submitted to the Overseas Examinations Commission no later than Friday, September 27, 2013. If the application form is not returned to this office, the candidate will not be registered for the examination, even if payments have been made.
