Welcome to Ignite Academic Solutions
Learner'
s Details:
Learner ID
Enrollment Date:
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
Date
Full Name
*
First Name
Last Name
Phone Number
*
Format: (000) 000-0000.
WhatsApp Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
School Name
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phase:
*
Foundation Phase
Intermediate Phase
Senior Phase
FET Phase
Matric Rewrite
Grade
*
Current Grade
Type of Service:
*
One on One
Extra Classes (Group Sessions)
Online Classes
Group Online Classes with Mr. N Nzima ( R600 )
Subjects:
*
Mathematics
Mathematical Literacy
Accounting
Physical Sciences
Natural Sciences
Other
How did you hear about us?
*
Please Select
Social Media
Word Of Mouth
Pamplets
Outdoor Activations
Please Specify
*
Would you recommend us to your friends and family?
*
Yes
No
Maybe
You can recommend any two people for 10% Discount on your registration fee:
Rows
Full Name
Surname
Contact Number
Grade
1
2
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Parent's/Guardian Details
The person responsible for the account.
Name:
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
WhatsApp Number
*
Please enter a valid WhatsApp phone number.
Format: (000) 000-0000.
Email
example@example.com
Occupation
*
Type of Service:
*
One on One
Extra Classes (Group Sessions)
Online Classes
Group Online Classes with Mr. N Nzima ( R600 )
Payment Date:
*
-
Day
-
Month
Year
2 digit day, 2 digit month, 4 digit year
All fees must be paid by last day of each month
Signature
*
Do you give Ignite Academic Solutions (Pty) Ltd consent to post any graphics (picture or videos) which may include your child for any promotion or advertisement and your are aware that there would not be any compensation for it?
*
Yes
No
I read and understood the terms and conditions?
*
Yes
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BANK DETAILS
Bank name: Standard Bank Account holder: IGNITE ACADEMIC SOLUTIONS (PTY). Account number: 10 12 042 724 7. Account type: CURRENT Reference: LEARNER'S ID
Should be Empty: