MINISTRY OF EDUCATION / GHANA EDUCATION SERVICE
GHANA TVET SERVICE Quick Enrolment Code
COMPUTERISED SCHOOL SELECTION & PLACEMENT SYSTEM
(CSSPS)
ENROLMENT FORM
Application for Entry into Senior High Schools (SHS)/Technical & Vocational Institutes (TVI)
To be submitted to Head of Senior High School or Technical & Vocational Institute placed
(Any erasure renders this form invalid.) - 2024
INDEX NUMBER: 022206002024
TOTAL RAW SCORE (Four Core Subjects): 270
AGGREGATE: 12
SHS/TVI PLACED: New Juaben Senior High/Com
PROGRAMME: GENERAL SCIENCE
Enrolment Code:
SECTION A: PERSONAL DETAILS OF CANDIDATE
(To be completed by candidate)
Name: GBEDZE SELORM KODJO
Date of Birth: (DD/MM/YY) Place of Birth: Gender: Male
JHS Attended: DIVINE TRUST INTERNATIONAL SCHOOL
Town:
District: NSAWAM ADOAGYIRI MUNICIPAL
Region: EASTERN
Permanent Address:
Signature of Candidate:
SECTION B: PARTICULARS OF PARENTS/GUARDIANS
Name of Father:
Occupation:
Name of Mother:
Occupation:
Name of Guardian:
Postal Address:
Residential Address:
Residential Telephone:
Other Telephone:
Signature of Parent/Guardian:
Date (DD/MM/YYYY):
SECTION C: TO BE COMPLETED BY STUDENT
Indicate your interest:
(a) Athletics [ ]
Football [ ]
Debating Club [ ]
Others [ ]
(b) School Awards:
(c) Position Held:
(d) I, GBEDZE SELORM KODJO do accept that my admission into this school opens a new chapter in my life. i therefore pledge
to abide by all the rules and regulations of the school
Candidate Witness (Headteacher, Pastor, Snr. Public/Civil Servant,
Lawyer)
Name: Name:
GBEDZE SELORM KODJO
Signature: Signature:
Date (DD/MM/YYYY): Date (DD/MM/YYYY):
SECTION D:
(FOR PLACEMENT ONLY)
Name of Head of SHS/TVI:
Signature:
Date/Stamp:
Students Identity No. (If Any):