Common use of LEARNER INFORMATION Clause in Contracts

LEARNER INFORMATION. Surname: Official Name(s): Preferred Name: Date of birth Sex Commencement date: Religion Learner lives with – Mother Father Both Allergies Dietary requirements: Any special needs/learning difficulties/disabilities: ▇▇▇▇▇ score at birth: Medical Aid name: Medical Aid number: Main Member: Scheme: Name of Family Doctor: Contact No: 3pm DAYS ATTENDING PER WEEK: 3 days (1-2 class only) 5 days

LEARNER INFORMATION. Surname: Official Name(s): Preferred Name: Date of birth Sex Religion Commencement date: Religion Learner lives with – Mother Father Both Allergies Dietary requirements: Any special needs/learning difficulties/disabilities: ▇▇▇▇▇ score at birth: Medical Aid name: Medical Aid number: Main Member: _ Scheme: _ Name of Family Doctor: _ Contact No: 3pm DAYS ATTENDING PER WEEK: 3 days (1-2 class only) 5 days

LEARNER INFORMATION. Surname: Official Name(s): Preferred Name: Date of birth Sex Religion Commencement date: Religion Learner lives with – Mother Father Both Allergies Dietary requirements: Any special needs/learning difficulties/disabilities: ▇▇▇▇▇ score at birth: Medical Aid name: Medical Aid number: Main Member: Scheme: Name of Family Doctor: _ Contact No: 3pm DAYS ATTENDING PER WEEK: 3 days (1-2 class only) 5 days

LEARNER INFORMATION. Surname: Official Name(s): Preferred Name: Date of birth Sex Commencement date: Religion Learner lives with – Mother Father Both Allergies Dietary requirements: Any special needs/learning difficulties/disabilities: ▇▇▇▇▇ score at birth: Medical Aid name: Medical Aid number: Main Member: Scheme: Name of Family Doctor: Contact No: 12:45pm 2pm 3pm DAYS ATTENDING PER WEEK: 3 days (1-2 class under 3 only) 5 days