ACTApplicationForm

ENROLMENT APPLICATION FORM - ADVANCED CERTIFICATE IN FOUNDATION PHASE TEACHING 2025/2026

Edutel Higher Education is registered with the Department of Higher Education and Training until 31 December 2027 as a private higher education institution under the Higher Education Act, 1997. Registration Certificate No. 2017/HE07/001.· By completing and submitting this enrolment application form, you are applying to be enrolled as a student for a Course(s) offered by Edutel Higher Education.· In this application, “we”, “us” or “our” refers to Edutel Higher Education (Proprietary) Limited and “you” or “your” refers to the individual described in section A of this application.· This application includes the Terms and Conditions attached in Appendix 1.· You must complete all sections in full and sign in full where indicated.· You must provide us with a certified copy of your ID, latest salary advice and certified copies of your qualifications with your application. Also include proof of computer literacy course, if attended.
Student Number: ____________________
Please indicate whether you are a:*
Section A - Your Personal Details
Student Name*

TileSurnameFirst Names
Age (years)*
Sex*
Marital Status*
Race*
Home Language*
Citizen Status*
Disability Status*
If yes, please specify
ID Number*
SACE Registration Number
Postal Address*

Postal Address

Street Address Line 2

CityState / Province

Postal Code
Home Address*

Street Address

Street Address Line 2

CityProvince

Postal CodeCountry
Phone Number*

Area CodePhone Number
Mobile Number*

Area CodePhone Number
Email Address*
Employment Information
Are you currently employed as an educator?*

YesNo
If yes, what is the start date of employment

MonthDayYear
Date
Number of years experience in education
If yes, what is your position?
Province of employment
Name of school
Employer Telephone Number

Area CodePhone Number
Relative's Information (not living with you)
Relative's Name*

First NameLast Name
Relative's Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
Relative's Number (H)*

Area CodePhone Number
Relative's Number (W)*

Area CodePhone Number
Relative's Fax Number

Area CodePhone Number
Relative's Employer*

Section B - Your Scholastic/Tertiary Qualifications
Highest Grade Passed*
Other Certificates Completed
Diplomas Completed
Degrees Completed
You must be Computer (ICT) Literate to complete the Advanced Certificate in Foundation Phase Teaching. Are you Computer (ICT) Literate?*
Do you have a certificate or proof that you have completed a computer literacy (ICT) course?

YesNo
If you have a computer literacy course certificate or proof of attending a computer literacy course, please upload it here

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If you are computer (ICT) literate but don't have a certificate to prove it, sign here to confirm that you are computer literate - Simply use your mouse/laptop touch pad or finger to sign in the box below.
Do you have access to a*

ComputerLaptopiPadTabletNothing
If you are not computer (ICT) literate when you register for the ACT: Foundation Phase Teaching, you are requested to complete the declaration below.

I hereby declare that I am aware that I must be computer (ICT) Literate and I undertake to complete the online Computer Literacy workshop that I will receive after registration in order to acquire the skills needed to complete the ACT: Foundation Phase Teaching. I need to have my own computer with sound or a laptop including data/Wi-Fi to attend the training.

If I do not complete the online ICT workshop presented by Edutel, I undertake to provide Edutel with evidence that I have attended another computer literacy programme at a registered, reputable, training institution.
Signature - Simply use your mouse/laptop touch pad or finger to sign in the box below. *

Section C

If you are married in community of property, your guardian or spouse (if applicable) must complete the following declaration:
Are you married in community of property?*
Spouse Name*
Spouse ID Number*
Spouse Occupation*
Spouse Physical Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
Spouse Work Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
I as guardian or spouse of the student in Section A of this application, hereby declare that this application is being made with my permission, and that, where I am the guardian, I hereby bind myself as surety for, and co-principal debtor to the student in Section A of this application for the due and punctual performance of the said student’s obligation arising out of this agreement.
Signature of spouse - Simply use your mouse/laptop touch pad or finger to sign in the box below.*

Section E
May we contact you via SMS or email?*

SMSEmailOther
Which social media do you use?*

FacebookTwitterWhatsappSMSOther
If you have another number for Whatsapp other than the cellphone number you already listed, please indicate it here:

Section F - Debit Order Mandate

AUTHORITY AND MANDATE FOR DEBIT ORDER PAYMENT INSTRUCTIONS – Must be completed by all applicants, unless you pay cash for your course.
Authority given by (name of account holder)*
Address of account holder*

Street Address

Street Address Line 2

CityProvince

Postal Code
Bank Name*
Branch Name & Town*
Branch Number*
Account Number*
Type of account*

Current (Cheque)SavingsTransmission
Your salary pay day*
Today's date*

MonthDayYear
Date
REFER TO OUR CONTRACT DATE (“the Agreement)”I/we hereby authorise you to issue and deliver payment instructions to your banker for collection against my/our above mentioned account at my/our above mentioned bank on condition that the sum of such payment instructions will never exceed my/our obligations as agreed to in the Agreement.
Signature - Simply use your mouse/laptop touch pad or finger to sign in the box below.*
Signature of surety - Simply use your mouse/laptop touch pad or finger to sign in the box below.

Section G - Very important: If not completed it could delay the dispatch of your material

Should we dispatch your material via PAXI, which means you will collect your material at your nearest PEP Stores, we need the following information.
At which PEP Stores branch do you wish to collect your study material? Please provide the branch name.*
Please provide the branch town.*
Please provide the branch province.*

Section H
By signing below, you signify your acceptance of the Terms and Conditions that apply to this application, as set out in Appendix 1 to this application below.
Signed at (place)*
Today's Date*

MonthDayYear
Date
Signature of Student - Simply use your mouse/laptop touch pad or finger to sign in the box below.*
Please indicate the province and town where you prefer to write exams. New Examination Centres can be considered, pending the number of students wanting to write examinations at these centres. A written request can be directed to the Examination Officer. Edutel Higher Education will consider the best interests and safety of students when planning for examinations. This may lead to examinations not being held at actual centres, but will be replaced with online examinations. In such cases, students will be informed of such decisions well in advance. Note: If an insufficient number of students register to write examinations at a specific centre, students will be redirected to an alternative centre. If a student insists on writing at the specific centre (although there are not a sufficient number of students registered at that centre), they can enquire with the Head of Examinations as to what the requirements will be to make that possible.*
Declaration
I am fully aware that the programme I have enrolled on, that is, the Advanced Certificate in Foundation Phase Teaching, SAQA ID: 110648, NQF 06, is registered with the Department of Higher Education and Training to Edutel Higher Education (Pty) Ltd as indicated on the registration certificate dated 30 November 2021.
Today's Date*

MonthDayYear
Date
Student Signature*
Please upload a certified copy of your ID here*

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Please upload a certified copy of your qualifications here*

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1. If paying via Fundi study loan - please upload a recent copy (not older than 2 months) of your salary advice here. 2. If paying via debit order, please upload a recent copy of your bank statement confirming your bank account details here*

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Workplace Confirmation Letter
The following workplace confirmation letter needs to be submitted along with your application. Download a copy of the letter to be completed here: Workplace Confirmation Letter
Submit your completed workplace confirmation letter here. Should you not be able to submitit online now, please send the completed workplace confirmation letter to highereducation@edutel.ac.za

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ENROLMENT APPLICATION FORM - ADVANCED CERTIFICATE IN FOUNDATION PHASE TEACHING 2025/2026

Section A - Your Personal Details

Employment Information

Relative's Information (not living with you)

Section B - Your Scholastic/Tertiary Qualifications

Section C

Section D

Section E

Section F - Debit Order Mandate

Section G - Very important: If not completed it could delay the dispatch of your material

Section H

Declaration

Workplace Confirmation Letter