BASTION PRIMARY SCHOOL

FOR OFFICE USE ONLY
ADMISSION NUMBER
DATE OF ADMISSION
D / D / M / M / J / J
FAMILY CODE
PROOF OF ADDRESS
BIRTH CERTIFICATE
CLINIC CARD
DATE RECEIVED

APPLICATION FOR ADMISSION

APPLICATION FOR
SURNAME
FIRST NAME
PREFERRED NAME
ID. NUMBER
RACE
DATE OF BIRTH
RIGHT HANDED
LEFT HANDED / 2 / 0 / GRADE
WHITE / BLACK / COLOURED / OTHER
D / D / M / M / J / J / SEX / M / F

PARENTS / GUARDIAN INFORMATION

FATHER / INITIALS
SURNAME
PREFERRED NAME
ID. NUMBER
STREET ADDRES
POSTAL CODE
POSTAL ADDRESS
POSTAL CODE
TELEPHONE
(H) / CODE
(W) / CODE
(CEL)
E-MAIL ADDRESS
OCCUPATION
MOTHER / INITIALS
SURNAME
PREFERRED NAME
ID. NUMBER
STREET ADDRESS
POSTAL CODE
POSTAL ADDRESS
POSTAL CODE
TELEPHONE
(H) / CODE
(W) / CODE
(CEL)
E-MAIL ADDRESS
OCCUPATION

I WOULD LIKE TO SERVE THE SCHOOL IN THE FOLLOWING WAY:

Contacts (e.g. Wholesalers)

______

______

Examples:

Welding work / Transport
Paint work / Catering
Plumbing / Sponsors
Electrical wiring / Fund raising

CHILD IS RESIDENT WITH? (CIRCLE)

BOTH PARENTS / FATHER / MOTHER / GUARDIAN / OTHER

PERSON WHO IS RESPONSIBLE FOR THE PAYMENT OF SCHOOL FEES (CIRCLE)

FATHER / MOTHER / GUARDIAN

NEXT OF KIN (Not at your residential address)

SURNAME / INITIALS / TELEPHONE NUMBER / RELATIONSHIP
INFORMATION OF LEARNER / LANGUAGE
AFR / ENG / OTHER: SPECIFY:______
NUMBER OF CHILDREN IN FAMILY
POSITION OF LEARNER IN FAMILY / (1ST, 2ND, 3RD)
ELDEST OR ONLY IN SCHOOL / YES / NO

OTHER CHILDREN IN BASTION

NAME / GRADE
1
2
3

PREVIOUS SCHOOL/PREPRIMARY (Attending now or previously attended )

SCHOOL
ADDRESS
TEL. NUMBER
LAST DATE AT PREVIOUS SCHOOL/PREPRIMARY: / GRADE PASSED

GENERAL INFORMATION

ALLERGIES
MEDICATION
OPERATIONS

UNDERLINE THE ILLNESS(ES) THAT LEARNER HAS BEEN IMMUNISED AGAINST: (CLINIC CARD MUST BE ATTACHED )

POLIOMYELITIS AND TUBERCULOSIS (B.C.G.) (COMPULSORY BY LAW FOR ADMISSION) DIPHTHERIA; TETANUS; WHOOPING COUGH; HAEMOPHILUS INFLUENZA TPE B; MUMPS.

STATE ANY SERIOUS OR CHRONIC ILLNESSES (EG. ASTHMA, EPILEPTIC, ETC)

MEDICAL

NAME / NUMBER(S)
DOCTOR
MEDICAL FUND

DECLARATION

WE, THE UNDERSIGNED STATE THAT:

1 The content of the application form has been filled in correctly;

2 We have taken note of the school rules and admission policy;

3 We undertake to abide by the code of conduct, rules and policy as well as to respect and obey the morals and character of this school.

4 The parent guardian undertakes to pay the school fees as determined annually.

PARENTS/GUARDIAN SIGNATURE:______

NAME IN FULL :______

DATE:______

APPLICATION FOR ADMISSION

1 CERTIFIED COPIES of the following documents must be handed in with die enrollment form:

Ø  your child’s clinic card

Ø  your child’s identity document

Ø  proof of address (ONLY MUNICIPAL ACCOUNT OR SIGNED RENTAL AGREEMENT WILL BE ACCEPTED)

Ø  copies of both parent’s identity documents

Ø  proof of ORIGINAL report card from previous school of highest grade passed

Ø  ORIGINAL TRANSFER CARD from previous school (OBTAINABLE FROM YOUR SCHOOL ON LAST DAY OF ATTENDANCE)

Ø  CERTIFIED RESIDENT’S PERMIT (if not RSA citizen)

2 A deposit for admission in Grade R is payable. You will be notified of the amount at a later stage.

PROCEDURE FOR CONFIRMATION OF ADMISSION:

Ø  You will be notified in writing whether your application was successful. You, as parent, need to reply in writing whether you accept or not within 10 days.

Ø  WCED-policy states that you need to enroll at the school nearest to your residential address.

______

CD EKSTEEN

HEADMASTER

BASTION PRIMARY SCHOOL
LEARNER INFORMATION / Admission
Number
The complete and correct information on this form can save the life of your child. / Grade

LEARNER

Surname & name
Preferred Name
Date of Birth
Identity Number
Address

FATHER:

Relationship / Father Stepfather Guardian (Please Circle)
Surname & Full Name
Identity Number
Home Address
Occupation
Work Address
Tel No. (W) (H) (Cel)

MOTHER:

Relationship / Mother Stepmother Guardian (Please Circle)
Surname Full Name
Identity Number
Home Address
Occupation
Work Address
Tel No. (W) (H) (Cel)

OTHER CHILDREN IN BASTION

NAME / GRADE / TEACHER
1
2
3

NEXT OF KIN (Incase parents can not be reached)

NAME / CONTACT NUMBER / RELATIONSHIP

MEDICAL INFORMATION

NAME / NUMBER(S)
Doctor
Medical Aid
ALLERGIES / MEDICATION

12. I/we understand that the school reserves the right to verify all information supplied to them via this application. In the event of fraudulent documents submitted, the school reserves the right to lay a criminal charge of fraud against any of the parties to this application.

13. I/we accept responsibility of the learner’s transport to and from the school.

14. I/we undertake to inform the school promptly should the child be unable to attend school. Non-attendance at school for a period of more than 2 (two) days, or non-attendance at any end of term / year tests or examinations, will require a doctor’s certificate.

15. I/we undertake to support the school’s constitution and policy of admission, as defined and implemented by the Governing Body of the school.

16. I/we understand that smoking in school uniform and the abuse of any drug or alcoholic beverage is an infringement of the critical school rules and will not under any circumstances be tolerated.

17. The signatory hereto hereby chooses domicillium et executandi as indicated below. In the event of a change of address, parents are to notify the school in writing.

18. I/we accept responsibility for immunizing our child against contagious diseases and normal infections, and shall produce proof thereof if required to do so.

19. This commitment in its entirety will be valid from the day on which it is signed by the parent/guardian to the day on which the learner officially leaves the school.

CONSENT FOR EXCURSIONS

I, the undersigned (full name and surname) ______

Of (Home address) ______

Parent of (names of scholar) ______

______

Do hereby consent that my son/daughter may take part in all extra-mural activities of the school, including sports, cultural activities, educational tours, either by foot or by vehicle. I take cognizance of the fact that the Headmaster, his staff or parents involved, will provide such action as deemed reasonable under the circumstances for the safety and welfare of my child.

MEDICAL RULES

Give Bastion Primary School permission to use their own discretion, should any children sustain serious injuries at school.

______

SIGNATURE OF FATHER/GUARDIAN DATE

______

SIGNATURE OF MOTHER/GUARDIAN DATE

Dear Parents 26 October 2011

SPECIAL CIRCULAR : FINANCE

1.1 TUITION FEES 2012

At the budget meeting on 25 October 2011, the following was approved by the parents : the tuition fees for 2012 will be R 6050,00 per child per year for Grades 1 to 7. If you pay the full amount before 1 March 2012, you will receive a discount of 10%. The fees for Grade R for 2012 will be R6600,00 per learner per year but the discount will, however, not be applicable to them.

Kindly take note that tuition fees are a statutory debt which is prescribed by the SA Schools Act, (Act 84 of 1996) and may not be referred to a debt counsellor for debt review in terms of Section 129 of the National Credit Act, as schools are exempt from the provisions of the National Credit Act.

Tuition fees are levied on 1 January and may, with the approval of the School Governing Body, be paid in equal monthly payments. Fees are payable within the prescribed period of 11 months from January to November on or before the first business day of each month. The School Governing Body reserves the right to withdraw this privilege should payments fall into arrears. The School Governing Body will take legal steps at the end of each school term to clear the outstanding debt. Legal fees entailed will be payable by the debtor. In the case of neglecting payment of the prescribed tuition fees, the total outstanding amount will become payable immediately.

1.2 MEANS OF PAYMENT

Please complete the information on the back of this letter and return it to the school by 11 November 2011. The School Governing Body uses this information to determine the school’s cash flow so that all our goals and planning for the year can be co-ordinated effectively.

1.3 DEBIT ORDERS

Parents who pay by debit order must complete a new form every year (attached). Complete the form and send it back to the school by 11 November 2011. Learners who enrol during the course of the year must hand in their forms within one week of enrolment. It is your responsibility to ensure that the debit order has been deducted from your bank account every month. In the case of a debit order being refused by the bank, you will be liable for any costs involved. If your debit order is refused for two consecutive months, it will be cancelled immediately and you will be notified in writing. You will then be liable for the outstanding monthly instalment plus costs in cash/per internet to the school immediately.

1.4 EXEMPTION FROM SCHOOL FEES

Forms for partial/complete exemption from school fees are available from the school. The prescribed form must be filled in accurately and completely and handed in before 1 March 2012. Learners who enrol during the course of the year must hand in their forms within one week of enrolment.

______

CD EKSTEEN

(PRINCIPAL)

VOLTOOI INLIGTING EN STUUR TERUG AAN DIE SKOOL TEEN 11 NOVEMBER 2011

COMPLETE INFORMATION AND SEND BACK TO SCHOOL BY 11 NOVEMBER 2011

1 LEERDER(S) SE BESONDERHEDE / LEARNER(S) DETAILS

Meld asb. alle leerders wat in Bastion ingeskryf is/State details of all learners enrolled at Bastion

Naam en Van/ Name and Surname / Graad/Grade in 2012

1  OUER/VOOG SE BESONDERHEDE/ PERSONAL DETAILS OF PARENT/GUARDIAN

Vader/Father/Voog/Guardian / Moeder/Mother/Voog/Guardian
Van/Surname
Naam/Name
Titel/Title
ID no

3 KONTAKBESONDERHEDE/CONTACT DETAILS : VADER/FATHER

Adres/Address
Tel (Huis/Home)
Tel (Werk/Work)
Faks/Fax no
Sel/Cell no
E-pos/E-mail

4 KONTAKBESONDERHEDE/CONTACT DETAILS : MOEDER/MOTHER

Adres/Address
Tel (Huis/Home)
Tel (Werk/Work)
Faks/Fax no
Sel/Cell no
E-pos/E-mail

5 METODE VAN BETALING/METHOD OF PAYMENT (Merk met X /Mark with X)

Eenmalig voor 1 Maart 2012
Once off before 1 March 2012
Debietorder : 11 maande (1 Jan – 1 Nov)
Debit Order : 11 months (1 Jan – 1 Nov)
Kontant/Internet : 11 maande (1 Jan – 1 Nov)
Cash/Internet : 11 months (1 Jan – 1 Nov)
Ander wyse, bv met bonus (meld wanneer)
Alternative method, eg bonus (state when)

Ek neem kennis van die inhoud van hierdie spesiale omsendbrief en onderneem om die verpligte onderriggeld ten opsigte van my kind/ers te betaal. Ek onderneem ook om die finansiële kantoor te kontak indien my omstandighede dit nie toelaat dat ek my verpligting ten opsigte van skoolgeld kan nakom nie. / I take note of the contents of this special circular and undertake to pay the compulsory tuition fees with regards to my child/ren. I also undertake to contact the financial office at the school if my circumstances do not allow me to keep to my commitment with regards to the payment of school fees.

______

OUER/VOOG/PARENT/GUARDIAN DATUM/DATE

DEBIT ORDER

NUMBER : ______

I, the undersigned, request Bastion Primary School to arrange with my bank and Multi-Data to withdraw the amount, as authorised here, from my account.

Account Holder : ______

(Surname, first name and other initials)

Telephone : (H) ______(W) ______(Cell) ______

Address : ______

Name of Bank : ______Branch : ______

Bank account number : ______

Bank branch code : ______

Type of account :

CHEQUE SAVINGS TRANSMISSION

Date of first collection : 1 January 2011

Amount : ______

NAME OF LEARNER / S / Grade in 2012 / Amount

______

SIGNATURE OF ACCOUNT HOLDER DATE