Boshof High School: Application

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APPLICATION FOR ADMISSION TO SCHOOL: BOSHOF COMBINED SCHOOL

Note: This form must be completed in full. All changes to be initialed or signed by parent / guardian. Completing the form does not necessarily mean that the learner has been accepted into the school.

0.1 ID of Parent: Click the button below to take a snapshot of your ID using your phone or upload your ID from your files. Note: Image must be smaller than 2mb.
*

1.1 Grade Applied For: *
1.2 Highest Grade Passed: *
1.3 Year When Grade Was Passed: *
1.4 Accession No: *

2.1 First Name: *
2.2 Surname: *
2.3 Initials: *
2.4 Nick Name: *
2.5 Other Names: *
2.6 Gender: *
2.7 Date Of Birth:
2.8 Race: *
2.9 Country of Residence: *
2.10 If SA, indicate province:
2.11 ID or Passport Number: *
2.12 Citizenship: *

3.1 Physical Address: *
3.2 City / Suburb: *
3.3 Postal Code: *
3.4 Learner E-Mail Address: *
3.5 Learner Cell: *
3.6 Home Telephone: *
3.7 Emergency Telephone: *
3.8 Home Language: *
3.9 Perefered Language of Instruction: *
3.10 Boarder: *
3.11 Deceased Parent: *
3.12 Mode of Transport: *
3.13 Religion: *
3.14 For Grade 1 only: indicate pre-primary education: *

Previous School Information

4.1 Name of Previous School: *
4.2 Previous School Address: *

Learner Medical Information

5.1 Medical Aid Number: *
5.2 Medical Aid Name: *
5.3 Medical Aid Main Member: *
5.4 Doctor Name: *
5.5 Doctor Address: *
5.6 Doctor Telephone: *
5.7 Medical Conditions: *
5.8 Special Problems Requiring Counseling: *
5.9 Dexterity of Learner *
5.10 Reg. Social Grant *
5.11 Rec. Social Grant *

Siblings

6.1 Number of other children at this school: *
6.2 Position in the family (eg. first): *
6.3 Names & Grade of Siblings:
*

Parent / Guardian Information

7.1 Title: *
7.2 Initials: *
7.3 Name: *
7.4 Surname: *
7.5 Gender: *
7.6 Race: *
7.7 Home Language: *
7.8 ID Number: *
7.9 Account Payer: *
7.10 Residential Address: *
7.11 Occupation: *
7.12 Employer: *
7.13 Spouse Name: *
7.14 Spouse Surname: *
7.15 Spouse Occupation: *
7.16 Spouse ID Number: *
7.17 Relationship to learner: *
7.18 Leaner resides with parent(s): *
7.19 Marital status of parent: *

Correspondence Details

8.1 Title: *
8.2 Surname: *
8.3 Postal Address: *

Other Contact Details

9.1 Home Telephone: *
9.2 Work Telephone: *
9.3 Cellphone Number: *
9.4 E-Mail Address: *
9.5 Fax Number: *
9.6 Spouse Cellphone Number: *
9.7 Spouse Work Telephone Number: *
9.8 Spouse E-Mail Address: *

10. Confirmation & Consent

10.1 Yes, I hereby declare that to the best of my knowledge, the above information as supplied is accurate and correct.
10.2 Yes, I accept the conditions of admission.
10.3 Yes, I hereby give consent that my child may participate in the activities at school and may be transported by the school buses. I will not hold the school or the Department of Education liable for claims or expenses, in case of an accident. We as staff will endeavour to be cautious at all times.
10.4 Yes, we would also like to apply for residence at Vastrap Hostel.

Required fields are marked with *

Please feel free to phone [Contact Person] on [Contact Number] at anytime for telephonic assistance with regard to completing the application form.

Privacy statement: No copies of this submission will remain on your computer or on public internet. This transaction is private and confidential.