Secondary Application (#5) (#32)

P I M S

Port Moresby Institute of Matriculation Studies

APPLICATION FOR SECONDARY ENROLLMENT

(Please Take Note. We no longer offer the Formal Secondary Program in NCD)

Date

Photo

Choose File

First Name

Last Name

PIMS Centre

Grade Applied For (select and tick)

Grade 9 Secondary

Grade 10 Secondary

Grade 11 Secondary

Grade 12 Secondary

Enrollment Cayegory

New

Re - Enrolling

Transferring - In

How did you find out about PIMS?

Personal Details

First Name

Last Name

Gender

Home Province

District

LLG

Home Village

Marital Status

Religion

Date of Birth

Postal Address

Address Line 1

Address Line 2

City/Town

Province

Zip Code

Country

BMobile

Digicel

Landline (if applicable)

Residential Address

Educational Details

Last School Attended

Province

Highest Grade Completed

Year

Copy of Grade 8 certificate

Choose File

Copy of Grade 10 certificate

Choose File

Copy of other certificate

Choose File

Sponsor Details

Name of Sponsor/Guardian

Employer (if applicable)

Employment Address

Position

BMobile No (Sponsor)

Digicel No (Sponsor)

Landline No (Sponsor)

Email (Sponsor)

Fee Payment Option

Full Yearly Payment (one instalment)

Half Yearly Payment (two instalments)

Four equal quarterly or Term payments (four instalments)

Pay Deduction

Special Talents or Skills You Have

Health Condition

Your Future Career Interest

Why Have You Chosen To Enroll At PIMS?

Can you tell your other relatives and friends about PIMS?

Refund Policy

Refunds within 4 weeks of study commencement will suffer a 50% deduction penalty. No refund after 4 weeks of study commencement.

Declaration

By 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 Applicant

Date