MINISTERE DE L’ENSEIGNEMENT SUPERIEUR



MINISTRY OF HIGHER EDUCATION REPUBLIC OF CAMEROON

SAINT JEAN INSTITUTE Peace – Work – Fatherland

Registration Form for the Entrance Examination into the Computer Engineering Cycle (5-Year Study)

YOUR PERSONAL DATA / INFORMATION :

Are you already a holder of the GCE A LEVEL ? Yes □ No □

Year of Graduation : |__|__|__|__| Number of Papers and Points obtained : …………………........

Your Series in Upper Sixth (S1, S2, S3, S4) :

School :………………… …………………Town :

Number of students per class : Annual Rank :

1st Term Rank : 2nd Term Rank : 3rd Term Rank :

Your Results :

No of Papers and Points at O LEVEL :………………………………………………………

No of Papers and Points at A LEVEL (if you are already a holder of the A LEVEL) : .………………………………………………………………….

Have you ever repeated ? Yes □ No □

If yes, which class(es) ?

How have you heard of Saint Jean Institute ? ……………………………………………………………...

DEPOSIT RECEIPT

Secondary and Higher Education

|School Year |Class |School Name |Certificate |Year of Graduation |

| | | |Prepared | |

|2020-2021 | | | | |

|2019-2020 | | | | |

|2018 - 2019 | | | | |

|2017- 2018 | | | | |

|2016 - 2017 | | | | |

OTHER INFORMATION (on parents)

Write the words "READ AND APPROVED" Parents’ Signature Candidate’s Signature

Components of the File (if your file is not complete before the Entrance Exam, it does not matter, you submit it and complete it after):

1. Complete the Registration Form available

2. A copy of your NIC (or Receipt) or passeport ;

3. A School certificate;

4. A copy of the A Level Results Slip or Certficate (under reserve for USS students) ;

5. A copy of the O Level Results Slip or Certificate;

6. A copy of report cards from F5 to USS ;

7. 21 000 F CFA (non-refundable) as exam fees.

NB: No need to have your documents certified. A photocopy is sufficient.

Website : Mail : info@ Telephone : (+237) 657 07 98 07 / 651 36 96 96/ Adress : P.O BOX 749 – Yaounde – CAMEROON[pic][pic]

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Entrance Examination : Saturday 24th April 2021

Subjects : Mathematics, Physics, English

Exam Place : Saint Jean Institute (Simbock Etok koss)

Deadline for submitting the file : Friday 23rd April 2021

Place of filing: Prépa Vogt (Yaoundé), Saint Jean Institute (Yaoundé) or at the Guidance councellor’s or Dean of Studies or the VP’s Office of your School

Recent Identity Photo of the Candidate

Not to be Filled !

NIC

School Certificate

O Level Slip

A Level Slip.

F5 Report Card

LSS Report Card

USS Report Card

21 000 FCFA

Parents Signature

Names (in capital letters):

Surname :

Sex Male : Female : Check the corresponding box

Born the |__|__| |__|__| |__|__|__|__| At :

Nationality :

NIC No :

Region of Origin :

Complete Adress (u/c, P.O Box, quarter, etc.) :

Mobile Phone Number :

E-mail :

ENTRANCE EXAM INTO SAINT JEAN INSTITUTE

THE CANDIDATE WILL NOT BE ABLE TO WRITE WITHOUT THEIR ID AND THIS RECEIPT

Name and Surnames :

Date and Place of Birth :

NIC No :

Filing Date -----/[?] (8:*[pic]CJ aJ$h._yhX/t5?CJaJh._yh€`f5?CJaJh._yhÈiÿ5?CJaJh._yhÖ|i5?CJaJh._y5?CJaJh8iÉ5?CJaJh._yh._y5?CJaJ h#!Æ5?h._yh#!Æ5?h!5?CJaJh._yhüa[?]5?CJaJh._yhÈiÿ5?CJaJh+7^5?CJaJhš -----/ ------

Recent Identity Photo of the Candidate

Please Turn …

Stamp and signature of the person in charge

FATHER

Names and Surnames :

Occupation : …………………………………… Telephone No : …………………………………

MOTHER

Names and Surnames (maiden name) :

Occupation : …………………………………. Telephone No : ……………………………………

Parents' situation: Single – Divorced – Married – Seperated – Widow(er) Delete as inappropriate

No of Children in the Family:

No of Children in Higher Education:

Parents’ Adress :

Residence district (quarter): Home Cell No :

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