Application Form Please Fill Everything on Form Please enable JavaScript in your browser to complete this form.Name *FirstLastPrefered NameNationality *South AfricaOtherID/PASSWORD NUMBER: *RELIGIOUS DENOMINATION: ETHNIC GROUP:HOME LANGUAGE: *ChooseAfrikaansEnglishOther...LEARNERS LANGUAGE PREFERENCE: ChooseSame As AboveOtherADMISSION DATE: What Grade Are You? *ChooseGrade 8Grade 9Grade 10Grade 11Grade 12PRE-PRIMARY EDUCATION ATTENDED:ChooseFormalInformalOther...CheckboxesYesNoDO YOU HAVE ANY LEARNERS CURRENTLY/PREVIOUSLY IN THIS SCHOOL?FirstLastEMAIL *NEXT OF KIN INFORMATION *FirstLastCONTACT NUMBER: Relation With Next Of Keen *ChooseParentGaurdianOtherFAMILY INFORMATION– FAMILY STATUSChooseBOTH PARENTSSINGLE PARENT– UNMARRIEDSINGLE PARENT –DIVORCEDFOSTER CARE CHILDRENS HOMERE-COMPOSEDOTHERPARENTS DECEASEDNONEAny CHRONIC DISEASES, ALLERGIES and MEDICAL CONDITION *ChooseYesNoIf You Choose Yes, Please Explain Medical Condition:INFORMATION OF PREVIOUS SCHOOL/ PLAY GROUP/ NURSERY *School Contact Number:FIRST REGISTRATION IN LIMPOPO:YesNoLEARNER ATTENDED SCHOOL LAST YEAR: YesNoAge of Applying Student *I accept that the implementation of a Debit order for payment of school fees is compulsory, with the exception of once off annual payment and per term payments.Monthly (via debit order) AnnuallyPer TermSubmit
