AFRIKAANSE HOëRSKOOL SASOLBURG

APPLICATION FOR ADMISSION

(Print please.  Mark with an X where applicable)

                                                 OFFICE USE ONLY

GRADE	GROUP
REGISTRATION NUMBER

LEARNER INFORMATION

SURNAME
CHRISTIAN NAMES
CALL NAME
SEX (MARK WITH AN X)	MALE / FEMALE	BIRTH DATE
IDENTITY NUMBER
HOME LANGUAGE	AFR	ENG	OTHER :

ILLNESSES AND IMMUNIZATION                        

IS LEARNER ALREADY IMMUNIZED AGAINST THE FOLLOWING?	POLIO	DIPTHERIA	WHOOPING COUGH
ALLERGIES OR ANY OTHER ILLNESSES THAT LEARNER SUFFERED OR STILL SUFFERS FROM.
IS THERE ANY SPECIFIC MEDICAL CONDITION OR MEDICAL TREATMENT THE SCHOOL SHOULD KNOW ABOUT?  IF YES, THEN PLEASE ELABORATE.	YES	NO

 

PARENT/GUARDIAN INFORMATION

MR/MRS	INITIALS :	SURNAME :
POSTAL ADDRESS		STREET ADDRESS
TOWN & CODE		TOWN & CODE
TEL MOTHER WORK		TEL FATHER WORK
OCCUPATION MOTHER		OCCUPATION FATHER
HOME TELEPHONE		RELIGION
NUMBER OF CHILD-REN AT AFFIES	1 / 2 / 3 / 4 / 5 (CIRCLE)	PUPIL’S POSITION IN AFFIES	1ST / 2ND  / 3RD / 4TH / 5TH CHILD (CIRCLE)
MARITAL STATUS	MARRIED/DIVORCED	WIDOW/WIDOWER
VEHICLE INFORMATION	MODEL	MAKE	REGISTRATION NUMBER

REFERENCE TO FAMILY OR FRIEND                                     

MR/MRS (CIRCLE)	INITIALS :	SURNAME :
STREET ADDRESS		TEL NUMBER
TOWN & CODE

INFORMATION OF PREVIOUS SCHOOL        

NAME & ADDRESS OF SCHOOL
EXIT DATE
HIGHEST GRADE PASSED

WHERE DOES LEARNER STAY (MARK WITH AN X)

OWN PARENTS	1	WITH MOTHER (FATHER DECEASED)	5
STEPFATHER	2	WITH GUARDIANS	6
STEPMOTHER	3	PARENTS DIVORCED – LIVING WITH FATHER	7
WITH FATHER (MOTHER DECEASED)	4	PARENTS DIVORCED – LIVING WITH MOTHER	8

 

UNDERTAKING / CONDITIONS

I/We the undersigned (surname & initials) __________________________________________________

Address : ___________________________________________________________________________

Parent/Guardian of (surname & name) _______________________________ Grade ______ year _______

Hereby apply for the above-mentioned child to be admitted as a learner at AFRIKAANSE HOëRSKOOL under the following conditions :

1.             I/We choose the above-mentioned address as domicilium citandi et executandi and will report any change of address within 7 days.

2.             The Governing Body will apply the school fees within the LAW and as it is needed for the standard of education and progress of the school.  Adjustments will be made from time to time after consultation with parents to ensure education of a high standard.

3.                UNDERTAKING

                I/We as parents/guardian:

3.1                 Undertake to pay the annual school fees as agreed upon with the school and if I/We should neglect to pay, the full amount for the year is payable or claimable and I/We accept full responsibility for all legal expenses, including lawyers- and client fees, levies, and interest at the highest interest rates.

3.2                Accept responsibility for all damage caused by my child(ren).

3.3                Accept responsibility to have my child(ren) immunized against contagious diseases eg. Measles, chicken pox, etc.  We undertake to keep the child(ren) at home until the child(ren) is cured from such disease or until the danger of infection has passed.

3.4                Undertake to return all books, borrowed from the school, when requested and to carry all costs of all items that are damaged when returned.  I/We also undertake to pay the governing body for all books and equipment not returned when leaving the school, at current prices.

3.5                Accept the responsibility of transporting my child(ren) to and from school.

3.6                Undertake to inform the principal of any absence and to produce a medical certificate if requested.

4.                INDEMNITY

                I/We as parents/guardians

4.1                 Acknowledge that the present insurance package of the school accommodates general claims up to  R1 000 000-00.  The school and Governing Body accept no responsibility for losses, injuries or casualties inflicted on the child during normal school activities and therefore the parent/guardian indemnifies the school against any claims not covered by the above-mentioned insurance.

4.2                Give the school power of attorney to decide on emergency medical care and to accept the implications thereof if parents/guardians cannot be contacted immediately.

4.3                Acknowledge that any equipment or property of the learner is brought onto the school grounds at own risk.

5.             I/We accept the attached admission policy of the school.

6.             The above undertaking will be operative from the day of signing until the learner officially leaves the school.  The Governing Body has the right to reconsider all applications and admissions.

7.             The parent/guardian declares that he/she is the legal parent/guardian of the child and entitled to sign this undertaking and that he/she is personally responsible for all aspects of the undertaking.

I/We confirm the I/We have read the conditions and understand them and we accept the responsibility for any amount due to the school.

SIGNED on the _______ day of (month) __________________ (year) _________

_____________________                             _______________________                _______________________

SIGNATURE FATHER/                                SIGNATURE MOTHER/                      PRINCIPAL

GUARDIAN                                           GUARDIAN

*        BOTH PARENTS MUST SIGN

ADMISSION REQUIREMENTS OF AFRIKAANSE HOëRSKOOL

CRITERIA FOR THE ADMISSION OF PUPILS TO

AFRIKAANSE HOëRSKOOL

1.                   All parents, guardians and pupils are expected to accept the ethos with regard to a Christian education.

2.                  The educational policy of Afrikaans Hoërskool must be accepted as the educational and tuitional norms which will apply to the tuition of the learners.

3.                  Each learner will have to show proof of conduct and the highest level of education passed at previous institutions.

4.                  Each learner will have to show proof of his/her age.

5.                  Parents/guardians will be expected to buy the correct school uniforms.

6.                  School fees are compulsory.

7.                  The Governing Body accepts no responsibility for the transport of learners.

8.                  All learners have to adhere to the rules as set by the Governing Body.

9.                  Non-Afrikaans-speaking learners will be taught in English as part of the school’s parallel-medium language policy.

I accept the above admission policy.

________________________________

SIGNATURE OF PARENT/GUARDIAN

PRINT NAME : ________________________   DATE: __________________

UNDERTAKING WITH REGARD TO PAYMENT OF

SCHOOL FEES FOR 2003

REGISTRATION FEE            :            R300-00 per pupil (payable at registration)

I/We as Mr/Mrs ______________________________ parent(s)/guardian of

___________________________ Grade _________ undertake to pay school fees.

I/we accept that failure to meet agreed payments without making arrangements to that effect with mrs L Jacobs or Mr Thys Swanepoel of the Governing Body, will result in being handed over to the school’s attorneys.

SIGNATURE:__________________________DATE: __________________

CHOICE OF PAYMENT

(CIRCLE YOUR CHOICE)

1.                   Ten equal payments per month before or on the SEVENTH of every month from FEBRUARY to NOVEMBER.

2.                  90% of the total amount before the END OF JANUARY, which implies a 10% discount.

NOTE

School fees for Grade 12 learners shall be paid in full before the LAST day of the THIRD term.

UNDERTAKING WITH REGARD TO SCHOOL FEES FOR 2003

PARENTS/GUARDIAN INFORMATION (PLEASE UPDATE THIS INFORMATION)

MR/MRS	INITIALS :	SURNAME :
POSTAL ADDRESS		STREET ADDRESS
TOWN & CODE		TOWN & CODE
TEL MOTHER WORK		TEL FATHER WORK
MOTHERS OCCUPATION		OCCUPATION FATHER
TEL HOM		PUPIL’S ADMISSION NUMBERS
NUMBER OF CHILD-REN AT AFFIES	1 / 2 / 3 / 4 / 5 (CIRCLE)	PUPIL’S POSITION IN AFFIES	1ST / 2ND  / 3RD / 4TH / 5TH CHILD (CIRCLE)
MARRIAGE STATUS	MARRIED/DIVORCED	WIDOW/WIDOWER
VEHICLE INFORMATION	MODEL	MAKE	REGISTRATION NUMBER

I/We as Mr/Mrs ______________________________ parent(s)/guardian of

___________________________ Grade _________ undertake to pay school fees.  Registration fees is R300-00 and MUST be paid before or on 15 January 2003 before any books will be handed out to a pupil.  The school fees is R2 700-00 and the first payment is payable the end of January 2003.

I/We accept that failure to meet agreed payments without making arrangements to that effect with mrs L Jacobs or mr Thys Swanepoel for the  Governing Body, will result in being handed over to the school’s attorneys, in which case I/We will be liable for all attorneys’ fees.  I/We also choose our above street address as domicilium citandi et executandi.

SIGNATURE:__________________________DATE: __________________

CHOICE OF PAYMENT

(CIRCLE YOUR CHOICE)

1.       Ten equal payments per month before or on the SEVENTH of every month from the end of JANUARY to the end of OCTOBER.  The school fees must be paid in full before the SEVENTH of November 2003.

2.      90% of the total amount before the END OF JANUARY, which implies a 10% discount.

NOTE

School fees for Grade 12 learners shall be paid in full before the LAST day of the THIRD term.