OPSA Tutor Centre Learner Registration (ver1.0)

Tutor Centre Name*
Name of Tutor Centre linked to the learner/s
Tutor Centre Email*

Confirmation Emailexample@example.com
How many learners do you want to register?*
Number of learners you want to register on this form. You can register up to four learners on this form. If you need to register more learners, please complete and submit additional forms.

Parent/Guardian Details:

Details of Parent/Guardian.
Parent/Guardian Title*
Prefix
Parent/Guardian First Name*
First Name
Parent/Guardian Surname*
Last Name
Parent/Guardian Email*

Confirmation Emailexample@example.com
Mobile Phone Number*
Please enter a valid phone number.
Learner Details:

Details of Learner
Learner Fist Name*
First Name (as per ID/Birth Certificate)
Learner Surname*
Surname (as per ID/Birth Certificate)
Learner preferred name*
Preferred name (for communication)
Learner ID Number*
ID (13 characters)
Learner Email*

Confirmation EmailEvery learner needs a unique e-mail address.
Please note: Every learner must have a unique email address.
Learner Email is a duplicate email. Please input another email address.
Learner Gender*
Gender
Learner Home Language*
Learner Teaching Medium*
Register the learner for:*
Phase*
Select the phase for "end of phase assessment"
Learner Grade*
Learner Starting Term at OPSA*

Parent/Guardian Details:

Details of Parent/Guardian.
Parent/Guardian Title*
Prefix
Parent/Guardian First Name*
First Name
Parent/Guardian Surname*
Last Name
Parent/Guardian Email*

Confirmation Emailexample@example.com
Mobile Phone Number*
Please enter a valid phone number.
Learner Details:

Details of Learner
Learner First Name*
First Name (as per ID/Birth Certificate)
Learner Surname*
Surname (as per ID/Birth Certificate)
Learner preferred name*
Preferred name (for communication)
Learner ID Number*
ID (13 characters)
Learner Email*

Confirmation EmailEvery learner needs a unique e-mail address.
Please note: Every learner must have a unique email address.
Learner Email is a duplicate email. Please input another email address.
Learner Gender*
Gender
Learner Home Language*
Learner Teaching Medium*
Register the learner for:*
Phase*
Select the phase for "end of phase assessment"
Learner Grade*
Starting Term at OPSA*

Parent/Guardian Details:

Details of Parent/Guardian.
Parent/Guardian Title*
Prefix
Parent/Guardian First Name*
First Name
Parent/Guardian Surname*
Last Name
Parent/Guardian Email*

Confirmation Emailexample@example.com
Mobile Phone Number*
Please enter a valid phone number.
Learner Details:

Details of Learner
Learner First Name*
First Name (as per ID/Birth Certificate)
Learner Surname*
Surname (as per ID/Birth Certificate)
Learner preferred name*
Preferred name (for communication)
Learner ID Number*
ID (13 characters)
Learner Email*

Confirmation EmailEvery learner needs a unique e-mail address.
Please note: Every learner must have a unique email address.
Learner Email is a duplicate email. Please input another email address.
Learner Gender*
Gender
Learner Home Language*
Learner Teaching Medium*
Register the learner for:*
Phase*
Select the phase for "end of phase assessment"
Learner Grade*
Learner Starting Term at OPSA*

Parent/Guardian Details:

Details of Parent/Guardian
Parent/Guardian Title*
Prefix
Parent/Guardian First Name*
First Name
Parent/Guardian Surname*
Last Name
Parent/Guardian Email*

Confirmation Emailexample@example.com
Mobile Phone Number*
Please enter a valid phone number.
Learner Details:

Details of Learner
Learner First Name*
First Name (as per ID/Birth Certificate)
Learner Surname*
Surname (as per ID/Birth Certificate)
Learner preferred name*
Preferred name (for communication)
Learner ID Number*
ID (13 characters)
Learner Email*

Confirmation EmailEvery learner needs a unique e-mail address.
Please note: Every learner must have a unique email address.
Learner Email is a duplicate email. Please input another email address.
Learner Gender*
Gender
Learner Home Language*
Learner Teaching Medium*
Register the learner for:*
Phase*
Select the phase for "end of phase assessment"
Learner Grade*
Learner Starting Term at OPSA*

I understand that OPSA is not a school and that an OPSA account gives a learner access to the services offered on the OPSA platform, it does not constitute a registration for home schooling at the DBE.*

Agree
Should be Empty:

OPSA Tutor Centre Learner Registration