Application 2025

Application for Admission 2025

This form must be completed in full. All changes initialled or signed by parent / guardian. Completing this form does not necessarily mean that the learner has been accepted into the school. For ease of use, we suggest to use a PC or laptop to fill in the form

DETAILS OF LEARNER

Surname

Given name

Preferred name

Date of birth

ID Number or Passport no

Race

Gender

Male
Female

Province of residence

Country of Residence

Learner's Physical Address

Current Language of Instruction

Home Language

Current grade of Learner

Name of Previous School Attended

Previous School Address

Previous School Contact number

Previous School Principal Contact Details

Previous School email address

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

Contact numbers

Relationship

SIBLINGS

Number of siblings in the school

Position in the Family (First/Second/Third etc.)

Please supply full names and surnames below:

PERSON RESPONSIBLE FOR SCHOOL ACCOUNT AND CORRESPONDENCE

Surname

Name

Title and initials

ID Number

Residential address

Postal code

Work number

Cell number

Email

Occupation

Name of employer

Employer Physical address

Postal Code

PARENT / GUARDIAN INFORMATION - MOTHER

Surname

Name

Title & Initials

ID Number

Home language

Race

Maritsal status

Residential address

Work number

Cell number

Email

Occupation

Name of employer

PARENT / GUARDIAN INFORMATION - FATHER

Surname

Name

Title & Initials

ID Number

Home language

Race

Marital status

Residential address

Work number

Cell number

Email

Occupation

Name of employer

GENERAL INFORMATION

With whom does the learner reside?

Both parents
Mother only
Father only

Other

Religion

Mode of transport

Deceased parent

Mother
Father

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