APPLICATION FOR ADMISSION
Grade applying for
*
Year of application
*
Accession no
*
Surname
*
Name
*
Given Name
Preferred Name
Date of birth
*
-
Month
-
Day
Year
Date of birth
ID or Passport no
*
Race
Gender
*
Male
Female
Country of Residence
*
Country of residence
Province of Residence
*
Please Select
Gauteng
Eastern Cape
Free State
Kwazulu Natal
Limpopo
Mpumalanga
Northern Cape
North West
Western Cape
Province
Learner's physical address
*
Street Address
Street Address Line 2
City
Province
Postal Code
Name of previous school attended
*
Previous school address
*
Street Address
Street Address Line 2
City
Province
Postal Code
Previous school contact details
*
T
Principal
Previous school contact email
*
example@example.com
Current language of instruction
*
Home language
*
FOR GR 1 ONLY
Indicate pre-primary education
*
Non-Formal
Formal
Dexterity of learner
*
Please Select
Right Handed
Left Handed
ambidextrous
MEDICAL INFORMATION
Name of medical aid
Medical aid number
Main member
Family Dr's name
Doctor's contact number
Please enter a valid phone number.
Format: (000) 000-0000.
Doctor's physical address
Street Address
Street Address Line 2
City
Province
Postal Code
Medical conditions
*
Chronic medication
*
Allergies
*
Special problems requiring counselling
CONTACT PERSON IN CASE OF EMERGENCY (NOT A PARENT, someone close by)
Name and Surname
*
First Name
Last Name
Relationship
*
Contact numbers
*
Please enter a valid phone number.
Format: (000) 000-0000.
SIBLINGS
Number of siblings in the school
Position in the family
*
(First /Second / Third, etc.)
Please supply full names and surnames below
1.
2.
3.
4.
PERSON RESPONSIBLE FOR SCHOOL ACCOUNT AND CORRESPONDENCE
Surname
*
Name
*
Initials
Initials
Title
Residential address
*
Street Address
Street Address Line 2
City
Province
Postal Code
Email
*
example@example.com
Work Number
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Employer
Employer physical address
Street Address
Street Address Line 2
City
Province
Postal Code
Occupation
PARENT / GUARDIAN INFORMATION - MOTHER
Surname
*
First Name
*
Initial
Title
Gender
Male
Female
Home language
*
Race
ID Number
*
Marital status of parent
*
Please Select
Single
Married
Divorced
Widowed
Seperated
Relationship to learner
*
Residential address
*
Street Address
Street Address Line 2
City
Province
Postal Code
Email
*
example@example.com
Work Number
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Employer
Occupation
PARENT / GUARDIAN INFORMATION - FATHER
Surname
*
First Name
*
First Name
Initial
Title
Gender
Male
Female
Home language
*
Race
ID Number
*
Marital status of parent
*
Please Select
Single
Married
Divorced
Widowed
Seperated
Relationship to learner
*
Residential address
*
Street Address
Street Address Line 2
City
Province
Postal Code
Email
*
example@example.com
Work Number
Please enter a valid phone number.
Format: (000) 000-0000.
Cell Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Employer
Occupation
GENERAL INFORMATION
With whom does the learner reside?
*
Please Select
Both Parents
Mother only
Father only
Other (Describe)
*
Religion
Mode of transport
*
Deceased parent
Please Select
None
Both Parents
Mother
Father
Dunamis education centre offers exciting promotions such as invitations to exclusive events and will communicate these to you by SMS and / or email. Do you wish to receive this communication
*
Yes
No
File upload
Documents need to be certified and certification must not be older than three months.
Certified copy of ID Photo of Learner
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Certified copy of Clinic Card
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Certified copy of Birth Certificate
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Transfer Card/Letter from the previous school
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Original Latest Report Card
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Copy of Psychological / Therapist Reports (if any)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Copy of Medical Aid Card (both sides)
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Certified Copy of both parents’/legal guardians’ ID Document/Passport
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Certified copy of proof of residence
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Certified copy of learner permit for foreign nationals
Browse Files
Drag and drop files here
Choose a file
Cancel
of
DUNAMIS CHRISTIAN SCHOOL signed Policy and Procedures documents
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit
Should be Empty: