Elmar College Enrolment Form

YesNo

Applying for grade:*

Select the grade for 2021

Name*

First NameLast Name

Phone Number*

ID number*

RSA residents - Enter learner's ID number International Students - Please enter your Passport Number

Learner's date of birth*

Date

Learner's Age*

MaleFemale

Address*

Street Address

Suburb

CityState / Province

Postal / Zip Code

Home Language:*

ParentsLegal GuardianRelative

YesNo

Means of Transport to School*

Taxi Driver Contact Number

Area CodePhone Number

YesNo

Name*

Full NamesLast Name

Designation*

ID Number*

As on ID document

Relationship to learner*

Marital Status

Nationality*

Country of Origin

Contact Number - Cell*

Phone Number

Phone Number - Home

Area CodePhone Number

Email*

Confirmation EmailThe e-mail addresses in both blocks should match

Occupation*

Employer*

Phone Number - Work*

Area CodePhone Number

Residential Address*

Street Address

Suburb

CityProvince

Area code

Postal Address

PO Box

Suburb

CityProvince

Postal Code

Work Address*

Street Address

Suburb

CityProvince

Postal Code

YesNo

Name*

Full NamesLast Name

Designation

ID Number*

As on ID document

Relationship to learner*

Marital Status

Nationality

Country of Origin*

Contact Number - Cell*

Phone Number

Phone Number - Home

Area CodePhone Number

Email*

example@example.com

Occupation*

Employer

Phone Number - Work

Area CodePhone Number

Residential Address*

Street Address

Suburb

CityProvince

Area code

Postal Address

PO Box

Suburb

CityProvince

Postal Code

Work Address

Street Address

Suburb

CityProvince

Postal Code

Name of School*

Previous School

Address

Address of previous school

Province

Province of previous school

Principal

First NameLast Name

Contact number

Area CodePhone Number

Fax number

Area CodePhone Number

Last grade passed

MathematicsMaths Literacy

Family Doctor*

First NameLast Name

Phone Number*

Area CodePhone Number

Address*

Street Address

Suburb

CityProvince

Postal Code

Medical Aid Information*

NameMain Member

Main member ID*

ID number of main member

Medical Aid Scheme*

Plan/Scheme name

Medical Aid Number*

Membership Number

YesNo

If yes, please provide details

YesNo

If yes, please provide details

YesNo

If yes, please specify

The school reserves the right to utilise the quickest Medical services avialable in case of emergency.

I,*

Parent name

being the Parent/Legal Guardian of:*

Learner name

hereby agree that a Medical Practitioner may provide emergency treatment as may be necessary, on my child.

Another contact in case of emergency:*

Name and SurnameRelationship to learner

Contact number - Work*

Area CodePhone Number

Contact number - Cell*

Phone Number

Email*

example@example.com

Who is the Account Holder?*

If Other, please specify

First NameLast Name

Details of learners in your care, currently at Elmar College.

Phone Number*

Area CodePhone Number

Name - Child 1*

Name and SurnameGrade

Name - Child 2

Name and SurnameGrade

Name - Child 3

Name and SurnameGrade

Name - Child 4

Name and SurnameGrade

Payment Option*

Declaration of Account Holder:

We the undersigned,*

Name and Surname

hereby certify that the information given by the Account Holder in this Application for sunbmission is complete and accurate.

We accept joint and several responsibility for the due and punctual payment of the annual non-refundable registration fee, school fee and any other amounts which may become due and payable to the school or in respect of participation in or attendance of any extracurricular activity.

We accept the Finalcial Terms and Conditions of which a copy is avaialble at the Financial Office at Elmar College.

Signature - Account Holder*

Sign by clicking and holding down mouse or touch pad

Date signed*

Signature - of Parent / Legal Guardian*

Sign by using mouse button or touch pad

Date signed*

This Section must be completed by both parents/legal guardians

We the undersigned,*

Name and Surname of both parents/legal guardians

Do hereby declare as follows:

1. I/We have legal custody and/ or guardianship in respect of the above named learner/s
and entitled to sign this document and shall be bound hereto both as parent/ guardian and in my personal capacity;

2. In the event of non-payment of fees, the School may pursue both parents irrespective of maintenance and/ or court orders which may exist between the parties;

3. Fees are payable in ELEVEN equal months. The first instalment is due on the first day of school each year and the final instalment is due by the 1st November.
A registration fee is payable with the application for admission. This fee covers administration expenses and is not refundable.

4. If payment is not received by the 7th of the following month, the school reserves the right to charge interest on all overdue accounts at the rate of 2% per month on the outstanding balance then due.

5. Should no agreement be reached for the repayment of all outstanding and/ or arrear school fees the school will hand the matter over for legal collection in which event the full year's fee will immediately become due, owing and payable;

6. The signatory/ies hereto chooses their domicillium citandi et executandi address for service of all and any documents as indicated in the admission application as their residential address;

7. In the event of a change of address and contact numbers parents to notify the school in writing;

8. The school reserves the right to verify all information supplied to them via this application either by way of a credit enquiry and/or credit information bureau, persons acting as their agents and/ or credit grantors;

9. The school reserves the right to exclude learners whose fees are not fully paid and is the right of admission to the school's premises strictly reserved.

10. The school has the right to take action to recover any outstanding amount in a court of a South African law in which case the parents are liable for and consent to pay costs and interest to any attorney on the attorney and own client scale, this sum including any collection commission and tracing fees.

11. In the event where an existing account is/has not been managed in a proper manor, Application for the next year will not be considered

Signature - Mother/Legal guardian*

Sign by clicking and holding down mouse or touch pad

Signature - Father/Legal guardian*

Sign by clicking and holding down mouse or touch pad

Date signed*

ELMAR COLLEGE

Section A

Father/Step Father/ Legal Guardian

Mother / Step Mother / Legal Guardian

Current or Previous School

Subject Choices

Subject Choices

Medical Information

Medical Details Consent

Account Holder

Financial Policy