APPLICATION FOR ADMISSION TO GRADE R (basic info applies to all grades)
at Johannesburg School for Blind, Low Vision and Multiple Disability Children
For Office use only:
Admission/Pupil No: / Account No:Date of Admission: / Grade R
A B C
Johannesburg School for Blind, Low Vision and Multiple Disability Children
35 Lothbury Road, corner St Swithin’s Avenue, Auckland Park 2092
Gauteng, South Africa
Shared Office: 58 Auckland Avenue (opposite no. 93), Auckland Park 2092
Tel: 011 726 6529 Fax: 011 482 4258
Shared Email:
Website: under construction: www.joburgblindschool.org
The Grade R programme at the Johannesburg School for Blind, Low Vision and Multiple Disability Children is run as a private facility. The school is registered with the Gauteng Department of Education.
Progression to Grade 1 at Johannesburg School for Blind, Low Vision and Multiple Disability Children is not automatic.
Closing date for receipt of application is usually 31st August or the closest working day, in the year preceding admission into Grade R.
Emails of acceptance or regret can be sent upon provision of an email address.
A non-refundable deposit of R2000 will be required on acceptance. This includes the year’s Braille paper and other stationary and the balance will be credited to your school fees account during the last term of the year.
Our pupils are currently not obliged to wear school uniform.
School fees are due on the first day of each of our four terms, payable monthly or per term by a debit order, cheque, electronic or direct payment.
School fees for 2012 are R18000 a year, which includes Brailler repairs, lunch, swimming and music lessons and local outings to the theatre, the Zoo, Zoo Lake, Delta Park and similar. The week-long excursion to the sea by train or by bus in October usually costs an additional sum but it is partially-subsidised from the school fund.
Fees are payable in full in advance, on or before the first day of each term. Failure to pay school fees (or any portion thereof) timeously could result in you being asked to remove your child from the school.
Application for Grade 1 or other grades requires completion and submission of this or a similar form.
Note: The following documents must accompany this application:-
Copy of child’s birth certificate and Road to Health Chart (clinic card)
Copies of both parents’ identity documents or passports if they are foreign nationals.
Certified verification of address (if rates account not possible, an affidavit from the landlord).
Note: A term’s written notice is required when leaving, or one term’s fees will be charged in lieu of notice.
Handing in an application does not guarantee an interview
Unsuccessful applications will be kept on a waiting list on request, for the current year only.
It is advisable to apply to more than one school.
Aftercare has limited places and is available for pupils from Grade R- Grade 5
Clarify if Aftercare from 2pm to 4pm is required.
In rare circumstances, places are made available for weekly boarders. These pupils would normally be brought on a Monday morning at 7a.m and collected on a Friday at 2pm. The boarding fee is currently R1000 a month in addition to tuition fees and covers all meals as well as additional excursions.
I/We have read and accept all of the above statements:
……………………………(Mother) …………………………….(Father)
PUPIL’S DETAILS:
Surname of pupil………………………..First name(s)………………………………...
Date of Birth: day……month……year……….Place of birth……………………......
ID No: …………………………………SA Citizen? Yes No
Residential Address of pupil………………………………………………………….
……………………………………………………………………. Code……………..
Tel No: …………………… Who does he/she live with?......
Grade R required for (year)…….. Name of present pre-school…………………….
Address of pre-school………………………… School Tel No ( )…………………..
Are pre-school fees paid up to date?...... What are the fees: Per month: R…………. or Per term: R……..
Other pre-school(s) attended……………………………………………………………
Number of children in the family……… Is pupil 1st, 2nd, 3rd child in family?......
Home language of pupil ………………… Religious Affiliation……………………
Religious Education: The school encourages the pupils to understand the key aspects of all world religions. Religious clothing may be worn and dietary needs can be met e.g. no pork, no beef, Halal or Kosher food, vegetarian. We do not support fasting by children for religious reasons, as it affects their concentration at school.
Important illness(es) from which the pupil is suffering or has suffered (e.g. Asthma, Epilepsy) and/or operation(s) pupil has had.
Give date and nature of operation(s)
…………………………………………………………………………………………..
Eyesight conditions:
Normal
Totally blind
Nystagmus
Partially blind
Low Vision
Submit ophthalmic surgeon report if available, or latest eyesight test.
Underline illness(es) pupil has been immunised against: Tuberculosis (B.C.G.), Diphtheria, Whooping cough, Tetanus, Measles, German Measles (Rubella), Mumps, Poliomyelitis and Haemophilus Influenza Type B (HIB), Meningitis, Yellow Fever, Papilloma.
Any previous connection with this school? If yes, please state: ……………………….
CONSENT AND INDEMNITY
I,…………………………………………………………………………… (full name)
Address:…………………………………………………………… Code …………….
the parent/ legal guardian of ………………………………… do hereby consent to my child participating, for as long as he/she remains a pupil at Johannesburg School for Blind, Low Vision and Multiple Disability Children, in extra-mural activities of the school, including sports, educational tours and excursions and to being transported to or from or during such activities by any teacher, parent or other person appointed for this purpose by the Principal of Johannesburg School for Blind, Low Vision and Multiple Disability Children or his/her assignee. I fully understand and accept that such activities and transportation shall be undertaken at my child’s own risk and I undertake personally and on behalf of my said child, in so far as I am legally able, not to institute any action against the School, the Principal or member of staff or volunteer, or the driver or the owner of any vehicle involved in any such transportation, for the recovery of damages suffered by my child or me, while participating in any such activities or transportation, in the knowledge that the Principal and his/her staff will, nevertheless, take all reasonable precautions for the welfare of my child.
………………………………..…. ……………………..
Signature of Parent/ Legal Guardian Date
PARTICULARS FOR ALL PARENTS/ GUARDIANS
BIOLOGICAL FATHER:-
Mr/Dr.etc………Surname……………………First names……………………......
Marital status: Married Divorce: Single: Remarried: Widowed:
ID No:………………………………. Email:…………………………………………..
Occupation………………………………. Name of Firm……………………………...
(or nature of business if self-employed)
Tel. No (W)……………………….(H)………………….Cell No…………......
Address: (Home)………………………………………………….. Code……………...
BIOLOGICAL MOTHER:-
Mrs/Dr.etc………Surname………………………First names…………………………
Marital status: Married Divorce: Single: Remarried: Widowed:
Occupation………………………………. Name of Firm……………………………...
(or nature of business if self-employed)
Tel. No (W)……………………….(H)………………….Cell No…………......
Address: (Home)………………………………………………….. Code……………...
DECLARATIONI agree that should the information provide in this application not be true and correct, the application will become null and void. The school takes no responsibility for checking the veracity of the application.
I agree to be responsible for my child’s behaviour and to see that she complies with policies and rules.
I am aware of the school fees for which I am jointly and severally liable, and the fees instalment that is required on acceptance, and I acknowledge that I am able to pay all school fees in respect of my child/children as laid down by the Governing Body, and I undertake to do so timeously. I agree to be responsible for my child’s fees until he/she leaves the school.
I am also aware that should I fail to pay school fees or any portion thereof on due date, that the Governing Body shall be entitled to take legal action to recover these arrears and that I will be liable for all the legal costs associated with such recovery.
I agree that I will adhere to regulations made by the school relating to traffic in the vicinity of the school, in the interest of the safety of pupils and consideration for others, and that I will convey these to anyone fetching or dropping my child on my behalf. I also agree to abide by the Municipal Traffic Regulations.
Signed…………………....(Father) Signed……………………………….(Mother)
Both parents must sign
In the case of Step-parents/ Guardian please sign………………………………………
state whether Stepfather, Stepmother, Guardian
Date……………
In the case of Step-Parents or Guardians please complete
STEPFATHER:-
Mr/Dr.etc………Surname……………………First names……………………......
Marital status: Married Divorced: Single: Remarried: Widowed:
ID No:……………………………….
Occupation………………………………. Name of Firm……………………………...
(or nature of business if self-employed)
Tel. No (W)……………………….(H)………………….Cell No…………......
Address: (Home)………………………………………………….. Code……………...
STEPMOTHER:-
Mrs/Dr.etc………Surname……………………First names……………………......
Marital status: Married Divorce: Single: Remarried: Widowed:
ID No:……………………………….
Occupation………………………………. Name of Firm……………………………...
(or nature of business if self-employed)
Tel. No (W)……………………….(H)………………….Cell No…………......
Address: (Home)………………………………………………….. Code……………...
GUARDIAN:-
Mrs/Dr.etc………Surname……………………First names……………………......
Marital status: Married Divorce: Single: Remarried: Widowed:
ID No:……………………………….
Occupation………………………………. Name of Firm……………………………...
(or nature of business if self-employed)
Tel. No (W)……………………….(H)………………….Cell No…………......
Address: (Home)………………………………………………….. Code……………...
Relationship to child……………………………………………………………………
2013 notes:
Term 3: 15th July to 27th September inclusive.
Term 4: 2nd October to 13th December inclusive.
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