APPLICATION FOR ADMISSION

 

 

 

 

 

Grade applying for Year of Application Accession no

WHERE DID YOU HEAR ABOUT OUR SCHOOL

Social media Referred by GDE Web site search
Flyer Referred by another school Friend/Family member

 

LEARNER'S DETAILS

Surname
Given Name
Preferred name
Date of birth Year:   Month: Day:
ID or Passport no
Race
Gender
Country of Residence
Province of Residence
Learner's physical address
Name of previous school attended
Previous school address
Previous school contact details     Principal 
Previous school email address
Current language of instruction
Home language

 

FOR GR 1 ONLY

Indicate pre-primary education       Dexterity of learner   

 

MEDICAL INFORMATION

Name of medical aid
Medical aid number
Main member
Family Dr's name
Doctor's contact number
Doctor's physical address
Medical conditions
Chronic medication
Allergies
Special problems requiring counselling
CONTACT PERSON IN CASE OF EMERGENCY (NOT A PARENT, someone closeby)
Name and Surname
Relationship
Contact numbers

 

SIBLINGS

Number of siblings in the school
Position in the family   (First /Second / Third, etc.)

Please supply full names and surnames below

1. GR
2. GR
3. GR
4. GR

 

PERSON RESPONSIBLE FOR SCHOOL ACCOUNT AND CORRESPONDENCE

Surname
Name
Initials
Title
Residential address
Postal code
Email address
Work number
Cell number
Employer
Employer physical address
Postal code
Occupation

 

PARENT / GUARDIAN INFORMATION - MOTHER

Surname
First Name
Initials
Title
Gender
Home language
Race
ID Number
Marital status of parent
Relationship to learner
Residential address
Postal code
Email address
Work number
Cell number
Employer
Occupation

 

PARENT / GUARDIAN INFORMATION - FATHER

Surname
First Name
Initials
Title
Gender
Home language
Race
ID Number
Marital status of parent
Relationship to learner
Residential address
Postal code
Email address
Work number
Cell number
Employer
Occupation

 

GENERAL INFORMATION

With whom does the learner reside?   Other (Describe)
Religion
Mode of transport
Deceased parent

 

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