Online Admission Application

Application Progress

REFERENCE

11% – General Information
22% – Learner Information
33% – Previous School Information
44% – Learner Medical Information
55% – Siblings
66% – Parents / Guardian Information
77% – Correspondence Details
88% – Other Contact Details
100 – Upload Documents & Verification

Year

Highest Grade Passed

Grade Applying for

Year When Grade Was Passed

Assession No

Surname

First Name(s)

Initials

Other name(s)

Date of Birth

Gender

Male

Female

Race

Other (specify)

Identification or Passport no

Country of Residence

Citizenship

If SA (South Africa), indicate province of residence

Physical Address

City / Suburb / Town

Code

Home Telephone

Emerency Telephone

Learner Cell

Learner E-mail Address

Home Langauge

Preferred Langauge of instruction

Boarder

Deceased Parent

Mode of Transport

Religion

Other (Specify)

Name of Previous School

Previous School Address

Country

Province

Code

Medical Aid Name

Medical Aid Number

Medical Aid Main Member

Doctors Name

Doctors Address

Doctor Telephone Number

Medical Condition

Special Problems Requiring Counselling

Dexterity of Learner

Right Handed

Left Handed

Ambidextrous

Registered Social Grant

YES

Number of other children at this school

Position in the family (e.g. first-born)

Name of Sibling (A)

Grade of Sibling (A)

Name of Sibling (B)

Grade of Sibling (B)

Name of Sibling (C)

Grade of Sibling (C)

Title

Initials

Surname

First Name(s)

Gender

Male

Female

Home Language

Race

Other (specify)

Identification or Passport no

Account Payer

YES

Residential Street Address

City / Suburb / Town

Code

Occupation

Employer

Surname of Spouse

First Name of Spouse

Occupation of Spouse

Learner resides with this parent/s

YES

Spouse ID Number

Relationship to Learner

Marital Status

Title

Surname

Postal Address

City / Suburb / Town

Code

Home Telephone

Fax Number

Work Telephone

Cell Number

E-mail Address

Spouse Work Telephone

Spouse Cell Number

Spouse E-mail Address

Copy of Immunisation Records

Copy of Birth Certificate

Progress Report from Previous School

Transfer Letter from Previous School

Full names of Parent / Guardian (Please Print)

Signature of Parent / Guardian (Please Print Initials and Surname)

Date

I, applicant attest that the information provided to be accurate according to my knowledge

YES NO