Transcript the FET 2015 application form

Application Form
2015
JBAY ACADEMY
LEARNER NAME:__________________________
GRADE: _________________________________
APPLICATION FOR 2015
NON REFUNDABLE REGISTRATION FEE OF R450 PAYABLE ON SUBMISSION OF APPLICATION
Banking details: Jbay Acdemy, Standard Bank Branch code:050315, account number: 252461398
Reference – Students name.
NAME OF LEARNER:
GRADE APPLYING FOR:
CURRENT SCHOOL:
LEARNERS MEDICAL INFORMATION
MEDICAL AID:
MEDICAL AID NO:
MAIN MEMBER:
NAME OF GP:
GP TEL:
ALLERGIES:
IMMUNISATION:
SPECIAL MEDICAL PROBLEMS REQUIRING COUNSELLING:
LEARNER DETAIL
FULL NAME AND SURNAME:
DATE OF BIRTH:
HOME LANGUAGE:
HOME ADDRESS:
PLACE OF CHILD IN THE FAMILY (1ST, 2ND, 3RD CHILD):
OTHER DETAIL
PLEASE INDICATE ANY APPROPRIATE INFORMATION IN THE FOLLOWING AREAS
PHYSICAL DISABILITIES:
LEARNING DISABILITIES:
SOCIAL DISABILITIES:
PLEASE INCLUDE THE FOLLOWING
COPY OF MOST RECENT SCHOOL REPORT
COPY OF ANY PROFESSIONAL REPORTS
COPY OF THE BIRTH CERTIFICATE
OTHER DETAIL
MOTHER NAME:
WORK ADDRESS:
WORK TEL:
CELL:
EMAIL:
FATHER NAME:
WORK ADDRESS:
WORK TEL:
CELL:
EMAIL:
EMERGENCY CONTACT (OTHER THAN PARENTS):
WHO WILL COLLECT THE CHILD AT THE SCHOOL:
TEL:
SCHOOL FEES
1. Who will be responsible for the school fees:
2. Payment method
CASH
DEBIT
EFT
3. School fees are payable in advance by the 1st of each month.
4. The parents must be aware that the school fees are payable in respect of any and each
individual academic school year (12 months).
5. SCHOOL FEES: R1250
6. Parents are jointly and severely liable in the personal capacities for the payments of the
school fees.
7. In event of the parents being in default of payment of the school fees-interest at the
rate of 20% per annum will be levied on all such amounts which are due as calculated
from the date upon which it became payable.
8. Legal steps will be instituted against them without prior notification for the recovery of
such arrear fees in which event the parents will be liable for all legal costs and expenses
as between attorney and own client including such collection commission which may
lawfully become due . Cancellation – 2 months notice .
RESPONSIBILITIES OF THE LEARNER
•LEARNER MUST BEHAVE IN ORDERLY MANNER
•MUST ACCEPT DISCIPLINE WHICH IS NECESSARY FOR THE GOOD FUNCTIONING OF THE
ACADEMY
•ATTEND ACADEMY FAITHFULLY
(if not parents are to inform us by either telephone or email)
NAME OF PARENT
NAME OF PARENT
_____________________
______________________
SIGNATURE OF PARENT
SIGNATURE OF PARENT
_____________________
DATE ______________
_______________________
SIGNATURE OF JBAY ACADEMY ______________________