Black November Promotion
Fill out the form carefully to register for January 2021 at a discounted rate. Promotion valid until 30/11/2020
Student information
Please fill in the following student information
Student Name
*
First Name
Middle Name
Last Name
Birthday
*
Gender
*
Male
Female
N/A
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student E-mail
*
example@example.com
Mobile Number
*
-
Area Code
Phone Number
Student stages and subjects
Please note that this information is just preliminary, stages and subjects will again be confirmed before January 2021
Stage / level
Stage 1-2
Stage 3-4
Stage 5
Stage 6
Stage 7
Stage 8
Stage 9
IGCSE
Primary (stage 1-9) subject choices
Afrikaans
English
Mathematics
Science
ICT
Art and Design
Global Perspectives (only for stage 7-9)
Introduction to French Foreign Language (additional fee per month)
Introduction to Spanish Foreign Language (additional fee per month)
IGCSE subject choices
Afrikaans
English
Mathematics
Physics
Chemistry
Biology
Computer Science
Business Studies
Accounting
History
Geography
German for IGCSE (additional fee per month)
Guardian information
Please fill in the following guardian information
Gaurdian Name 1
*
First Name
Middle Name
Last Name
Guardian 1 ID Number
Guardian 1 Contact number
*
-
Area Code
Phone Number
Guardian 1 Email (NOT SAME AS STUDENT)
*
example@example.com
Gaurdian Name 2
First Name
Middle Name
Last Name
Guardian 2 ID Number
Guardian 2 Contact number
-
Area Code
Phone Number
Guardian 2 Email (NOT SAME AS STUDENT)
example@example.com
Additional Comments
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