Believe - Achieve - Succeed. llerton rimary chool 229 Main Road, Three Anchor Bay, 8005

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1 Believe - Achieve - Succeed E P S llerton rimary chool 229 Main Road, Three Anchor Bay, 8005 PLEASE INSERT A COLOUR I.D. PHOTO WITH APPLICATION APPLICATION FOR ADMISSION Office: Fax : ellertonps@gmail.com ALL APPLICATIONS MUST BE FULLY COMPLETED TO BE CONSIDERED. ALL INFORMATION AND SUPPORTING DOCUMENTS OF BOTH PARENTS TO BE PROVIDED. INCOMPLETE APPLICATIONS WILL BE PLACED ON A WAITING LIST Current Grade 2018 Learner s name (birth certificate) Grade 2019 Date of birth: AGE REQUIREMENTS: Form number: Date received Learner s surname (birth certificate) Cemis number GR R: 6yrs in 2019 GR 1: 7yrs in 2019 Admission number: Person received CERTIFIED COPIES OF THE FOLLOWING A copy of the child s Birth Certificate A copy of the child s Clinic Card A copy of the latest Report Card A copy of a recent Utility Account (proof of address) Transfer form end of year only Identity Document of parents/guardian Recent Payslip + 3 month bank statement of both parents Non-South Africans: Permit for residence/study permit (bring original) Foreign Nationals: Evidence from Home Affairs (bring original with) Addendum A WHO IS RESPONSIBLE FOR DIRECT SUPERVISION OVER THE LEARNER? FULL NAME:.... Contact number/ .to be notified in case of an emergency: ( )... A non-refundable amount of R must be paid within 14 days of receiving an acceptance letter from the school (deducted from 2019 school fees) Please note this is only an application form, not a guarantee that your child will be accepted. Please make application at more than one school to ensure your child is enrolled for 2019.

2 SURNAME SECOND NAME NEW LEARNER FIRST NAME THIRD NAME DIACRITICS LEARNER IDENTITY RACE DATE OF BIRTH GENDER a.street/plot/ Farm/Flat NUMBER HOME ADDRESS b. Name OF Street/Plot/Fa rm/flat c. Suburb / ADD d. Town / Address e. Postal Code Tel CODE FOREIGNER (No SA ID) FIRST TIME REGISTRATION AT WESTERN CAPE PROVINCE SCHOOL? IN WHICH PROVINCE OR COUNTRY DID THE LEARNER ATTEND SCHOOL LAST YEAR? IF OTHER, PLEASE SPECIFY: LEARNERS GRADEDTHIS YEAR: STATEFOR SGB/R3 FUNDED CLASS? TELEPHONE NUMBER LEARNERS PARENTS DECEASED THEDSNE LEARNER IS: LEARNERFCLASS THIS YEAR: ATTEND SCHOOL LAST YEAR? HOSTEL BORDER THIS YEAR? HOSTEL SCHOOL IS THE LEARNER REGISTERED FOR A SOCIAL GRANT? DOES THE LEARNER RECEIVE A SOCIAL GRANT? LEARNER ATTEND ANY FORMAL OR N- FORMAL PREPRIMARY PROGRAMS? (applies to Gr1 enrolments only)

3 PARTICULARS OF PARENT(S): PARENT 1: RELATION TO CHILD: DECEASED: TITLE: FULL NAMES AND SURNAME: MARITAL STATUS (Tick One): Married Divorced Single Separated Widower Remarried OCCUPATION (WHAT IS YOUR JOB): ID NUMBER (IF RSA CITIZEN): PASSPORT NUMBER (IF T A RSA CITIZEN): CITIZENSHIP: RESIDENTIAL ADDRESS: POSTAL CODE: TELEPHONE NUMBER (HOME): ( ) (CELL WORK: ( ) EMPLOYER/COMPANY NAME: ADDRESS: POSTAL CODE: ************************** PARENT 2: RELATION TO CHILD: DECEASED: TITLE: FULL NAMES AND SURNAME: MARITAL STATUS (Tick One): Married Divorced Single Separated Widower Remarried OCCUPATION (WHAT IS YOUR JOB): ID NUMBER (IF RSA CITIZEN): PASSPORT NUMBER (IF T A RSA CITIZEN): CITIZENSHIP: RESIDENTIAL ADDRESS: Postal code: TELEPHONE NUMBER (HOME): ( ) (CELL (WORK): ( ) EMPLOYER/COMPANY NAME: ADDRESS: POSTAL CODE:

4 PAYMENT OF SCHOOL FEES: PERSON RESPONSIBLE FOR THE PAYMENT OF SCHOOL FEES: RELATION TO LEARNER/PARENT: ID NUMBER: ADDRESS: POSTAL CODE: TELEPHONE NUMBER (HOME): (WORK): ( (CELL): ) EMPLOYER/COMPANY: OCCUPATION: ADDRESS: POSTAL CODE: IF T THE PARENT PROVIDE THE FOLLOWING DOCUMENTATION: ID/PASSPORT DOCUMENT RECENT PAYSLIP 3 MONTH BANK STATEMENTS NAMES OF OTHER (SIBLINGS) LEARNERS ALREADY ATTENDING ELLERTON PRIMARY SCHOOL AT DATE OF APPLICATION AND WHO IS DEPENDANT ON THE SAME PERSON/S AS MENTIONED ABOVE: LEARNERS FULL NAMES GRADE ARE THE CURRENT SCHOOL FEES FOR THE ABOVE LEARNERS UP TO DATE IF : AMOUNT OUTSTANDING: R WILL YOU BE APPLYING FOR EXEMPTION (DISCOUNT) ON THE SCHOOL FEES? IF GIVE THE REASONS.... SCHOOL FEES FOR 2018 IS R FOR THE YEAR FEES WILL BE ADVISED IN VEMBER PARENTS PLEASE ENSURE THAT YOU CAN AFFORD THE SCHOOL FEES OF R PER MONTH AND PAY FOR TRANSPORT. THE ACCEPTANCE FEE OF R1600 WILL BE DEDUCTED FROM THE FOLLOWING YEAR S SCHOOL FEES.

5 UNDERTAKING TO PAY SCHOOL FEES Dear Parent/Guardian Public school fees are a statutory duty in terms of the South African Schools Act No. 84 of 1996(as amended). These school fees are payable annually in advance at the beginning of each school year and as such payment is compulsory unless I/we have been granted an exemption or partial exemption. However, purely in order to reduce the financial burden on parents, the school may extend the terms payable completely at its discretion. Should the School grant me such an indulgence, I accept that this undertaking in no way changes the fact that the payment of school fees is a statutory duty and not a voluntary agreement, particularly not a credit agreement as defined in terms of the National Credit Act No. 34 of Payment is made subject to the following terms and conditions: 1. If the School allows me/us any form of extended payment and I/we default and fail to pay any single instalment by due date, then the whole amount that s outstanding will become immediately due and payable. 2. I/we authorise Ellerton Primary School to carry out any checks and/or traces that they deem fit with any registered credit bureau or credit reference and also to list me with any credit bureau in the event of my defaulting in payment in terms of this agreement. 3. I/We chose the address specified as our residential address/es contained in this document as my/our chosen legal domicile for service of all legal notices and processes until I/we advise the school in writing of my/our new address, which will then become our new legal domicile. 4. That in the event that I/we are not the natural parent and/or guardian of the child/ren, then I/we accept responsibility of parent as defined in Section 1 of the Schools Act. 5. Understand that in terms of the Schools Act, parents are jointly and severally liable for school fees and any divorce order is inter partes binding between the parents and does not affect the parent s liability to the School. 6. I/We have been advised of the exemptions available to me/us on the school fees. 7. I understand that non-payment of any fees will result in my account been handed over to Debt Collectors.

6 UNDERTAKING TO PAY PUBLIC SCHOOL FEES I, (full name and surname of parent) (I.D. No. of parent) residing at (Address of parent) the undersigned, do hereby confirm that I accept responsibility as PARENT as defined in terms of the broader definition of parent in Section 1 of the SA Schools Act No. 84 of 1996 (the Act). This in terms of the education provided/ to be provided by Ellerton Primary School (the School) to: (Learner s name and surname) and specifically undertake to be responsible for the school fees of the said learner as set out in Section 40 of the Act, the details of which I acknowledge the School has advised me. I accept the above address as my chosen domilicium for service of all notices and legal documents unless I notify the school in writing of my change of address. I authorise the School to do credit bureau searches on me and in the event of any school fees due by me not being paid, I authorise the school to inform any relevant credit bureau and have my name listed with them. Signed at this day of 20 (SIGNATURE OF PARENT) Witness 1: Witness 2:

7 Name of school: School address: ADDENDUM A TO BE COMPLETED BY CURRENT SCHOOL / CRECHE Postal code: School telephone: Fax: This is to certify that was a learner at this school from to His/Her conduct during this period was: EXEMPLARY / GOOD / SATISFACTORY / T SATISFACTORY What are your annual school fees? Are the School fees paid up to date? R Are the School fees not paid up to date? Amount outstanding: R TO BE COMPLETED BY THE EDUCATOR: (Please tick appropriate comment) GOOD AVERAGE POOR CLASSROOM ATTITUDE Behaviour Concentration Works independently Task completion in set time Pride in written work SOCIAL & EMOTIONAL DEVELOPMENT Self-discipline Responsible Co-operates SUBJECTS: Ability English Ability Numeracy Ability Other languages (Rate these with 5 being strongest and 1 being weakest) Does the child require remedial intervention? /. If yes, please clarify. Are the parents involved in the life of the school? /. If explain: PRINCIPAL: SIGN: (Name & Surname) DATE: SCHOOL STAMP: