Grade 12 Upgrading Application (#3) (#25) (#30) (#31) (#41) (#42)P I M SPort Moresby Institute of Matriculation StudiesAPPLICATION FOR GRADE 12 UPGRADING(After completion, click Submit button below to send online)DateHow did you find out about PIMS? Ex students Friends Facebook Newspaper TV RadioPhotoChoose File First NameLast NamePIMS CentreStudy Program Applied For (select and tick) Pre Matriculation (Gr 10 Leavers) Adult Matriculation (Gr 10 Leavers) Adult Matriculation and Skills Training (Gr 10 Leavers) Grade 12 Upgrading (Gr 12 Leavers) Grade 12 Upgrading and Skills Training (Gr 12 Leavers)Study Mode Fulltime CorrespondenceEmployment Status Working Not workingEnrollment Category New Re - Enrolling Transferring - InHow did you find out about PIMS?Personal DetailsFirst NameLast NameGenderHome ProvinceDistrictLLGHome VillageMarital StatusReligionDate of BirthPostal AddressAddress Line 1Address Line 2City/TownProvinceZip CodeCountryAfghanistanAland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelauBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicDemocratic Republic of the Congo (Kinshasa)DenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRepublic of the Congo (Brazzaville)ReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (Dutch part)Saint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited Kingdom (UK)United States (US)United States (US) Minor Outlying IslandsUnited States (US) Virgin IslandsUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaYemenZambiaZimbabweBMobileDigicelLandline No (if applicable)EmailResidential AddressEmployment Details (if you are working)Employment Details for working correspondence studentsEmployer Employment AddressYour PositionWork Landline NoName of your Human Resource (HR) ManagerLandline No (HR Manager)Digicel (HR Manager)BMobile (HR Manager)Email (HR Manager)Email (HR Manager)Does your company/organisation have a school fee scheme for workers? Yes No Can be negotiatedEducational DetailsLast School AttendedProvinceHighest Grade completedYearCopy of Grade 10 certificateChoose File Copy of Grade 12 CertificateChoose File Copy of other CertificateChoose File Sponsor DetailsName of Sponsor/GuardianEmployer (if applicable)Employment AddressPositionBMobile No (Sponsor)Digicel No (Sponsor)Landline No (Sponsor)Email (Sponsor)Fee Payment Options Full payment upfront on enrolment (one instalment) Pay in instalmentsWhen can you pay your Fees? This week Next week Two weeks time Three weeks time Four weeks timeMethod you will use to pay your Fees Internet Mobile Banking Bank Deposit Pay Deduction Cheque Payment Overseas Bank TransferGrade 10 LeaversSubjects Applied For Basic English (ILS) Basic Math English 1 Math 1 Biology 1 Chemistry 1 Physics 1Grade 12 LeaversSubjects Applied For English 2 Math 2A (Advanced Math) Math 2B (General Math) Biology 2 Chemistry 2 Physics 2 Economics GeographySkills Training Courses (Optional)Skills courses can be taken by both Grade 10 and 12 Leavers Basic Computing Software Applications (Word, Excel, Publisher) Basic ICT (Information Communication Technology) Business Studies Basic AccountingSpecial Talents or Skills You HaveHealth ConditionYour Future Career InterestWhy Have You Chosen To Enroll At PIMS?Can you talk to other relatives, friends or workmates regarding PIMS online learning?Refund PolicyRefunds within 4 weeks of study commencement will suffer a 50% deduction penalty. No refund after 4 weeks of study commencement.DeclarationBy submitting this application, I the applicant, do solemnly declare that all information that I have provided above is true in every respect, and that I can be held liable for any false information. I pledge to abide by all the school's statutes and regulations while a student at this school. Signature of ApplicantDate Submit Form
