Entered in Database

Attach Passport Sized Photo

Here

Type of Picture I.D. & Number For further questions: Please contact the Division of Youth at 440-6917/18

One passport sized photo

A copy of academic and other certificates such as School Leaving, CSEC, CAPE, Associate Degree, etc.

Curriculum vitae

One signed reference letter from a reputable individual such as a Teacher, Principal, Pastor/Priest, or Past Employer IT MUST NOT BE A FAMILY MEMBER.

MEDICAL HISTORY

Please state any disability or serious illness

EMERGENCY CONTACT (NOT OPTIONAL)

Name of Person

Relation

Telephone: home and/or cell

PERSONAL INFORMATION

Last Name

Middle Initial(s)

First Name

Sex

M F

Marital

Single

Married

Common-Law Union

Separated/ Divorced

Nationality

Religion

If you are a parent, how many children do you have?

Age

Date of Birth

dd mm yy

GENERAL INFORMATION

Facebook Name

E-Mail Address (NOT OPTIONAL)

Telephone Numbers (NOT OPTIONAL)

Cell

Home Phone

BB PIN#

CONTACT INFORMATION

Street Parish

Constituency

Are you involved in any community, youth, church or sporting organization(s)?

Yes No If yes, please specify:

COMMUNITY INVOLVEMENT

HIGHEST EDUCATION LEVEL ATTAINED

Education Level

Secondary

TAMCC

NEWLO

Primary

University

Completed

Did Not Complete

Please indicate what component of the IMANI programme you are interested in (please choose ONE (1) component).

Community Development Initiative

Apprenticeship

(on-the-job training)

Enterprise (Small Business)

Direct Skills Training

IMANI PROGRAMME COMPONENT

1st Choice:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2nd Choice:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

General Construction

Hospitality Arts

Health Services

Electronics/Electrical Installation

Motor Vehicle Repair

Information & Communication Technology (ICT)

Media / Journalism

Teaching Assistant

Office Administration

Marine Industry

Music Production

Cosmetology

Agriculture

Craft Industry

Early Childhood Care

Roving Caregiver—Geriatric

If you have selected the Apprenticeship component, then please choose only TWO (2) areas listed below and place them in order of choice :

APPRENTICESHIP (ON-THE-JOB TRAINING)

PREVIOUS TRAINING

Have you participated in any of the Ministry’s skills training or apprenticeship exercise before? Yes No

Please write when (month and year); for how long you participated in the programme; and in what area:

If yes, which one? Apprenticeship Programme

(GYAP) Education & Training Programme

(GYET) Small Business Programme

(GYEI) IMANI

If you have selected the Skills Training component, then please choose only TWO (2) areas listed below and place them in order of choice:

DIRECT SKILLS TRAINING

IMANI PROGRAMME COMPONENT (continued)

Construction:

Brick/Block Laying, Rendering

Floor Covering & Finishing—Timber

Wall & Ceiling Lining Drywall Construction

General Construction

Electrical Installation

Concreting / Steel Fixing

Wall & Floor Tiling

Welding

Concreting

Masonry

Brick Laying

Plumbing

Painting

Carpentry

Motor Vehicle Repair:

Motor Vehicle Engine Systems

Motor Vehicle Repairs (Cars & Light Trucks)

Motor Vehicle Body Repairs (Cars & Light Trucks)

Motor Vehicle Transmission

Motor Vehicle Air Conditioning Systems

Beauty Services:

General Cosmetology

Nail Technology

Massage Therapy

Public Relations/Communication:

Camera Operations

Recording Engineering

Technical Assistance in TV & Video Production

Lighting Operations

Audio/Visual Editing Operations

Administration:

Customer Service

Data Operations

Library & Information Services (Library Clerk)

General Office Administration (Office Clerk)

General Maintenance/Repairs:

Small Appliance Repairs

Refrigeration & Air Conditioning

Building Maintenance

Mechanical Maintenance

Small Engine Repairs

Parks & Terrestrial Areas Maintenance

Health Services:

Geriatric Care

Health Care Assistance (Patient Care)

Fishery:

Inland Aquatic Operations—Tilapia Production

Education:

Early Childhood Development Design:

Graphic Arts

Floral Arrangement

Interior Decorating

Manufacturing/Production:

Furniture Making

Leather Goods Manufacturing

Ceramic Production

Handmade Soap Production

Jewellery Production— Leather

Jewellery Production— Seeds

Garment Production

Fabric Design

Soft Furnishing

Upholstery

1st Choice:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2nd Choice:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

Culture/Performing Arts:

Steel Pan Tuning

Musical Performance

Event Management

Hospitality Services:

Housekeeping— Houseman

Housekeeping— Laundry Attendant

Bar Service

Pastry Chef

Commercial Food Preparation (Cookery)

Customer Service

Agriculture:

Agro-Food Processing

Amenity Horticulture

Crop Production

Rabbit Production

Apiculture

Livestock

Poultry

APPLICANT’S SIGNATURE

DATE SIGNED (dd/mm/yy)

PLEASE SIGN & DATE

IMANI PROGRAMME COMPONENT (continued)

If you have selected the Community Development Initiative component, then please choose only TWO (2) areas listed below and place them in order of choice:

COMMUNITY DEVELOPMENT INITIATIVE

Community Geriatric Care

Community Sports

Community Youth Development

Disaster Management

Community Tourism

Security Services

After-School Tutoring

Child Care

Agriculture

1st Choice:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 2nd Choice:_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _

ENTERPRISE (SMALL BUSINESS)

If you have selected the Enterprise component, then please write the type of business you are interested in:

FOR OFFICIAL USE ONLY

Date Registration Form was Received

Registration Form Received By

Recommended Area of Engagement & Reason why

Applicant Form:

Approved Indicate reason below: Not Approved

Area of Trainee’s Attachment

Start Date (dd/mm/yy)

End Date (dd/mm/yy)

Indicate the name of training programme participant accessed: Applicant accessed training before?

Yes

No

Financial Institution Name & Account #

N. I. S. #

Required documents attached: CV Copy of Academics/ Other Certificates

Passport picture

Reference Letter

Picture I.D. (NIS, Passport, etc)