INTRODUCTION

Referred by

1. LEARNER INFORMATION

1.3 Known as

1.4 Address

1.5 Home Telephone

1.6 Date of Birth

1.7 ID number

1.8 Age

1.9 Sex

1.10 School currently attending

1.11 Current grade

1.12 Parent whom child is living with (If parents are divorced, separated or single)

2. FAMILY INFORMATION

2.1 Father's name & surname

2.2 ID number

2.3 Employer

2.4 Position

2.5 Business Tel No

2.6 Cell

2.7 Email

2.8 Mother's name & surname

2.9 ID number

2.10 Employer

2.11 Position

2.12 Business Tel No

2.13 Cell

2.14 Email

2.15 Marital status
MarriedWidowedDivorcedSeparatedSingle Parent

2.16 Deceased parent/s
NoneMotherFatherBoth

2.17 Other children in the family (Names, Age, and Current school)

3. CHURCH INFORMATION

3.1 Church affiliation

3.2 Church address

3.3 Pastor’s Name

3.4 Telephone No

3.5 Is father a committed Christian?

3.6 Is mother a committed Christian?

3.7 Has applicant ever made a profession of faith in Christ?

Particulars

4. MEDICAL INFORMATION

4.1 4.1 Family Physician

4.2 Telephone No

4.3 List any physical defects / allergies your child has

4.4 Has your child received immunization?
YesNo

Particulars

5. SCHOLASTIC INFORMATION

a. Has your child ever been expelled, dismissed, suspended or refused admission to another school?
YesNo

If yes, please give details

b. Has your child ever had any disciplinary difficulties?
YesNo

If yes, please give details

c. Has your child ever been in trouble with the law, arrested, etc.?
YesNo

If yes, please give details

d. Has your child ever used tobacco, drank alcohol, vaped or used drugs of any kind, to your knowledge?
YesNo

If yes, please give details

e. Please indicate academic level of pupil’s previous work
EXCELLENTGOODAVERAGEPOOR

f. Has your child ever failed?
YesNo

If yes, please give details

6. GENERAL INFORMATION

6.1 How did you hear about the school?

6.2 Give your reason for selecting this school

6.3 If divorced, separated or single, correspondence to be sent to (please select one)
Both parentsMother onlyFather only

7. THE FOLLOWING DOCUMENTS ARE TO BE HANDED IN WITH YOUR APPLICATION

A. Non-refundable Application Fee of R150.00 payable when you hand in this application.

B. Non-refundable Registration Fee of R1250.00 per child is payable on acceptance.

C. Your child’s year-end report and where applicable the latest term report

D. Unabridged Birth Certificate

E. Immunisation card

F. Recent Photograph

G. Copy of parents’ IDs

H. Diagnostic/Assessment Fee payable before assessment:

Grade R: R75.00

Grade 1 – Grade 3: R300.00

Grade 4 & up: R500.00

All applicants (Grade 2 and up) are required to write diagnostic tests in English, Social Studies and Mathematics to determine their correct placement in the school.

Should Shanan not accept this application after screening (tests, interviews etc.), the Diagnostic/Assessment Fee will go towards covering expenses incurred in the administration of this application.

I. If foreigners: A copy of valid passport and visa or proof of application to Department of Home Affairs to legalise stay in South Africa

J. If foreigners: A copy of the child’s study permit, or proof of application for it

Documents hand-in method
Upload documentsHand in physical copies at the school

Your child’s year-end report and where applicable the latest term report

Unabridged Birth Certificate

Immunisation card

Recent Photograph

Copy of parents’ IDs

IF FOREIGNERS: A copy of valid passport and visa or proof of application to Department of Home Affairs to legalise stay in South Africa

8. Agreement

e do hereby certify that we have read all the information provided with this application form and that the information we have provided in this form is complete, true and correct to the best of our knowledge.

Mother's Signature

Father's Signature

Signing date