Application & Pupil Details Application Information Application for Admission to Grade Year Pupil Details Surname First Name Date of Birth Identity No. Gender —Please choose an option—MaleFemale Home Language Emergency Contact Details Contact Person (other than parents) Relationship Telephone No. 1 Telephone No. 2 Family Doctor - Name Doctor's Telephone No. Allergies Handicaps Other Medical Info Required Documents Note: Max file size is 2MB per file. Accepted formats: PDF, JPG, PNG. File Attachments 1. Child's Birth Certificate (Certified) 2. Clinic card / 1 ID photo 3. Study/Refugee Permit (if applicable) 4. Copy of Parents ID (Certified) 5. Copy of latest report card 6. Transfer Card 7. Proof of Home/Work Address Family Details Father's Details Title & Surname First Name Known as Physical Address Postal Address Postal Code Mobile No. Work No. E-mail Address Identity No. Employer Position Mother's Details Title & Surname First Name Known as Physical Address Postal Address Postal Code Mobile No. Work No. E-mail Address Identity No. Employer Position Person responsible for the account Who will be responsible for fee payments? FatherMotherOther Primary Email for Correspondence & Billing (Required) If "Other", please provide Full Name, ID, and Contact Details: Other Children in Household Child 1 Name Child 1 Age Child 2 Name Child 2 Age Child 3 Name Child 3 Age Previous School Information Name of previous school Principal's Name Telephone No. Agreements & Signature Contract & Indemnity I hereby certify that the information provided by me/us in the application form(s) is true, complete and accurate. I undertake to comply with rules and regulations, code of conduct and disciplinary code of the Institute. I hold myself/ourselves accountable for the prompt payment of the Institute's fees. Indemnity: I hereby give permission for my child to participate in curricular and extra-curricular activities and excursions. Payment of Fees Selection I undertake to pay this fee (please select an option): Annually in advanceIn advance at the beginning of each termIn advance at the beginning of each monthBy debit order on the 1st of every month Data Privacy POPIA Consent: I consent to the collection, processing, and storing of personal information provided in this application for school administration purposes. Digital Signature Parent/Guardian Full Name (Signature) Date