RESIT – This is where the REPEAT – This is where the

student has the option to student has the option to

REUSE THEIR PREVIOUS DO OVER THEIR SBA.
SBA MARK. Consult with Consult with Subject
Subject Teacher First. Pleasantville Secondary School Teacher First.

CSEC CANDIDATE DATA CAPTURE SHEET

The following document is a FILLABLE FORM and MUST be Completed ACCURATELY

Shania Precious
FIRST NAME: _________________________ MIDDLE NAME: _________________________

Gumbs 02/19/2005
LASTNAME:__________________________ DATE OF BIRTH: _________________________
DD MM YY

Female
GENDER: _____________________________ 7957470083
BIRTH CERTIFICATE PIN #:_________________

5:5 gumbsshania9@gmail.com
CLASS: _______________________________ E-MAIL: _______________________________

289-5257
CELL: _________________________________

NEW Please State RESIT RESIT/PREVIOUS

SUBJECT (Type Resit in CANDIDATE NUMBER
SBA OR
Please
Transfer Box)

Additional Mathematics ✔ SBA

Biology ✔ SBA

Chemistry ✔ SBA

English A ✔ SBA

Physics ✔ SBA

Technical Drawing Building Computer Assisted Drawing ✔ SBA

Please Select Subject PLEASE SELECT

Please Select Subject PLEASE SELECT

Please Select Subject PLEASE SELECT

_________________
STUDENT SIGNATURE

CAPE and Repeat CSEC students, please ensure that you use the same name for this exam as it was
entered in the last examination period. Eg John Doe in 2006 should NOT be John Larry Doe in 2007.

Document Created By ICT Technical Officer Gary Persad