FORM E-002

NAME OF STUDENT

DATE OF BIRTH

ADDRESS

TELEPHONE

EMPLOYED

EMPLOYER

JOB DESCRIPTION

SELECT YOU EDUCATION STAGE

Primary Secondary Tertiary

HAVE YOU TAKEN ANY CORUSE(S) AT THE UWI 5 ISLAND CAMPUS?

Yes No

IF YES, ENTER YOUR UWI ID NUMBER

SELECT PROGRAM(S)

Harvard Credential of Readiness Professional Development Short Courses

I HEREBY DECLARE that the information provided in this registration form is true, complete, and accurate to the best of my knowledge. I UNDERSTAND that submission of this form constitutes an application for enrollment in programs offered by The University of the West Indies Five Islands Campus Lifelong Learning Unit and does not guarantee acceptance. I AGREE to abide by all rules, regulations, policies, and academic standards established by The University of the West Indies, including those governing student conduct, participation, and certification requirements. I CONSENT to the collection, use, and storage of my personal information for purposes related to my application, enrollment, academic progress, and institutional communication. I FURTHER CONSENT to being contacted by The University of the West Indies Five Islands Campus Lifelong Learning Unit and/or the Office of E. P. Chet Greene regarding my application status, course updates, program information, and related opportunities via email, telephone, SMS, or other electronic means as provided. I UNDERSTAND that I may opt out of non-essential communications at any time, subject to institutional policies.

University Registration & Course Selection Form (UWI Five Islands Campus)