Learner details. 1.1 Full name:
Learner details. 2.1 Surname:
Learner details. 1.1 Full name XXXXXXX XXXXXX XXXXXXX
Learner details. You acknowledge and agree that:
Learner details. Full name: __________________________________________________________ Identity number: _____________________________________________________ Date of birth: ________________________________________________________
Learner details. Surname: First Names: Known as: Date of birth: Gender: Home language: Place of birth: Religion: Nationality: SA Citizen: Yes| No| Current learning facility: Reason for leaving: PARENTS DETAILS FATHER/GUARDIAN (Person responsible for School Fees Account: YES NO ) Surname: First name: ID Numbers: Occupation: Name of employer: Cell Phone No.: Work No. Email address: Physical address: Vehicle (Make & Model): Registration No.: MOTHER/GUARDIAN (Person responsible for School Fees Account: YES NO ) Surname: First name: ID Numbers: Occupation: Name of employer: Cell Phone No.: Work No. Email address: Physical address: Vehicle (Make & Model): Registration No.: ALTERNATIVE CONTACT Surname: First name: Contact No.: Relation to child: Who does your child reside with? Name: Contact: Relation: MEDICAL INFORMATION Medical Aid: Membership No. Main Member: ID No. Family Doctor Name: _ Contact No. Doctor Address: Does your child have any allergies? If yes, please explain Are there any food or beverages your child should avoid? If yes, please explain Child weight at birth: Feeding(breast/bottle) Any problems during pregnancy/birth? Has your child been in any serious accident or encountered any traumatic situation? If yes, please explain Is your child on any chronic medication? If yes, please explain Is your child generally healthy? Does your child have a healthy appetite? Does your child have any habits that concern you? I/We hereby confirm that the information supplied by me/us is correct and that I/we will inform the school immediately in writing should any of the said information change. Signed at on 20 FATHER/LEGAL GUARDIAN MOTHER/LEGAL GUARDIAN PART B – FINANCIAL AGREEMENT Initial Parent(s)/Guardian(s) are hereby informed that a Financial Agreement will need to be completed and signed upon enrolment and for every following year for as long as the child(ren) remain enrolled at Umhlathuze Primary. All fees are payable on or before the 1st of the month in advance of the month attending and will be so charged until such time as written notice of cancellation is received by Umhlathuze Primary. Monthly school fees are payable even if your child is absent for any reason. Accounts that have not been paid with be handed to our attorneys for collection. Fees are billed for an 11-month year (Jan-Nov) Payments are to be made into the school account using your account reference number. All account queries must be referred to xxx@xxxxxx-xxxxxxx.xx.xx, alternatively by calling 000 000 ...
