Prep or 1st Form Cayo Christian Academy Application for 2012-2013

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1) $15.00 application fee 2) Fill out ALL of the application and attach a current passport size picture in the upper left hand corner of this application 3) Two Completed recommendation forms by Principal and one other person. 4) Attach a copy of Social Security Card, and Passport, or Valid Birth Certificate 5) Attach copy of Standard 5 and Standard 6 report cards from previous school 6) Copy of PSE result card. 7) Submit completed application form with supporting documents By June 8th, 2012

A. Name of Student: ____________________________________________________ (As appears on birth paper) Age: ________Male:_______Female:______ Date of Birth: _________________ Social Security Number____________________ Village: __________________________________________ Parents’ current Phone number: Mother_____________Father________________ Nationality: __________________________Place of Birth: _________________ (Birth certificate, social security or residency permit must be presented) In case of an emergency please provide 2 contact numbers: ____________________________________________________________________ What church do you regularly attend? ___________________________________ B. Name of primary caretaker (who you live with): _____________________________________________________________________ Father’s Name: ________________________________ Living___ or Deceased___ Address: _________________________________Nationality: ________________ Occupation: ________________________________________________________ Employer: _____________________________ Monthly Income: ______________ Mother’s Name: ___________________________ Living___ or Deceased___ Address: ________________________________Nationality: _________________ Occupation: ________________________________________________________ Employer: _______________________________Monthly Income: _____________ Will you have a sponsor to help you with your school fees? _____________________ If yes who will be sponsoring you? ________________________________________ If you do not have a sponsor, who will be financially responsible for your school fees? _____________________________________________________________________ Have you applied for Government Subsidy? ______________________ Languages spoken: English, Spanish, Creole, Mayan, Ketchi, other_______________

Prep or 1st Form Cayo Christian Academy Application for 2012-2013

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C. Education: Are you currently enrolled in school? ___ If yes, name, address and phone number of present school. ________________________________________________________________________

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Principal’s name: ______________________________________________________ If no, name of last school attended and Year: _____________________________________________________________________ Please provide official copy of scores Have you taken the PSE? ______ Overall Score_______ Scores for each Subject: English: ____Math:____Science:____Social Studies: _____ Have you applied for admission to any other high school? _____ Have you ever repeated a Standard / Grade? _________________________________ If yes, how many times and what Standard? ________________________________ __________________________________________________________________ List names of all schools you have attended (Starting from pre-school) __________________________________________________________________________________________________________________________________________ D. Letter of Recommendation from previous principal required. (Form for recommendation will be given)

Cayo Christian Academy is an evangelical nondenominational Christian school. As

such, it will foster and encourage a personal relationship with Jesus Christ and promote the Holy Bible as the holy and inerrant Word of God and the ultimate authority in matters of faith, morals and holy living. Students will receive training in academics, vocations and daily living skills. All students will be required to participate in some or all school related activities. I certify that all information on this application is correct and fully understand that any misrepresentation will disqualify this application. Parent or Guardian Signature: __________________________________ Date: _______________________ All information and recommendations must be present and completed for consideration. Submission of this application does not constitute automatic acceptance into CCA.