sans souci girls’ high school · sans souci girls’ high school esmé road, newlands 7700, cape...

SANS SOUCI GIRLS’ HIGH SCHOOL Esmé Road, Newlands 7700, Cape Town, South Africa Tel: +27 21 671 7188 / Fax: +27 21 683 4090 PO Box 44330, Claremont 7735, Cape Town, South Africa E-mail: [email protected] / www.sanssouci.co.za

_______________________________________________________________________________________________________

APPLICATION FOR ADMISSION By signing this application, you are binding yourself to the rules and regulations, as amended from

time to time.

In the case of a divorce, irrespective of the divorce agreement, both parents will be held responsible for the fees and must, therefore, both sign the application form.

This Application will NOT be processed until all the forms have been returned.

KINDLY LET US HAVE THIS COMPLETED FORM, TOGETHER WITH THE FOLLOWING:-

1. Annexure A - for completion by the Principal, who must email or fax it directly to the school (021) 683 4090,

OR return it via the Pupil (in a sealed envelope).

2. Annexure B - for completion by the Pupil.

3. Annexure C - for completion by Father and Mother, or Legal Guardian/s. (see Annexure C – 8.b)

4. Certified copy of your daughter’s UNABRIDGED Birth Certificate or application receipt thereof.

5. Certified copy of your daughter’s I.D. Document (if available).

6. Certified copy of your daughter’s Immunisation Card.

7. Certified copy of your daughter’s most recent School Report AND end of previous year’s Report.

8. Certified copies of the I.D. Documents of biological parents, Foster, Adopted, or Legal Guardian/s).

9. Certified copies of one of the following most recent accounts confirming name and address of Biological

Parents/Foster/Adopted or Legal Guardians: Bank Statement / Water and Rates / SARS (No other accounts

accepted.)

10. Parents of girls whose non-South African citizenship status requires that they have Residence and Study Permits are

asked to note the following:-

The onus is on the biological parent/foster/adopted or legal guardian to renew Residence and Study Permits.

Application must be made three months before Permits expire. (Inspectors do visit the schools.)

- No girl may be enrolled at the school, or be permitted to continue attending, unless a valid Residence and

Study Permit is in place. The originals must be presented to the school and we will make copies of these.

(N.B. There is a heavy fine for failure to have these Permits, as well as a risk of deportation.)

- No girl on a Study Permit will be granted any reduction in school fees.

N.B. Completed Application Forms are to be handed in at the School’s office.

Please note that the Application Process cannot begin unless ALL information has been

completed . No faxed copies will be accepted.

NB: HANDING IN OF AN APPLICATION FORM AND AN INTERVIEW DOES NOT GUARANTEE ACCEPTANCE

SIGNATURE : BIOLOGICAL PARENT/FOSTER/ADOPTED/LEGAL GUARDIAN (ONE) (Tick which one) ………………………………

SIGNATURE : BIOLOGICAL PARENT/FOSTER/ADOPTED/LEGAL GUARDIAN (TWO) (Tick which one) ……………………………...

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ NB (OFFICE USE ONLY)

Present School:

Remarks:

Interview:

Date: Time: Interviewer: Grade: Admission No.: Admission Date:

K: APPLICATION FORM 2020(Feb 2019)

Pupil’s Name:

Grade Required:

Date Admission: 2020

Parent’s Surname: (if different from Pupil)

mailto:[email protected]

http://www.sanssouci.co.za/

PUPIL’S DETAILS

1.1 Surname: ................................................................... First Names: ..............................................................

1.2 Sex: ............................................................ Home Language of Pupil: .....................................................

1.3 I.D. No.: ..................................................... Age: ................ Date of Birth: DD............. MM............. YY ...........

1.4 Place of Birth ............................................................... Nationality: ................................................................... (Certified copy of UNABRIDGED Birth Certificate or I.D. Document must be provided)

1.5 Number of children in family: ..................... Ages: .................... Number of daughters in family: .......................

1.6 Non-South African Citizens (Biological Parents/Adoptive Parents/Legal Guardians):

Country of Origin: ..................................................... Passport No.: .....................................................................

Date of arrival in South Africa: ................................... Relationship to Pupil: ...................................................

Are the Biological Parents/Adoptive Parents/Legal Guardians in possession of a temporary or permanent

Residence Permit issued by the Department of Home Affairs? (tick) YES [ ] NO [ ]

Does the Pupil have a valid Study Permit issued by the Department of Home Affairs?

(tick) YES [ ] NO [ ]

(ORIGINAL Residence and Study Permits must be provided)

1.7 Educational History

Present school: ........................................................................... Grade: ........................ Year: ......................

Physical address: ...................................................................................................................................................

Telephone no. of present school: (.......).......................................... Fax no.: (.......) .............................................

Any other school/s attended:

...................................................................................................... Grade: ........................ Year..........................

..................................................................................................... Grade: ....................... Year:.........................

1.8 Has Pupil failed any previous Grade(s)?: (tick) YES [ ] NO [ ]

If YES, state which Grade(s): ............................. (Attach certified copy of Pupil’s most recent school report and end of previous year’s report)

1.9 Sisters, or other relatives, at Sans Souci Girls’ High School at present or in the past:

Name Relationship Grade Year

..................................................... .......................................... ………………. ……………

..................................................... ………………………………… ………………. ……………

1.10 Siblings Please note that siblings are not necessarily accepted into the school.

1.11 Pupil’s Religious Affiliation: ...............................................................................................................

1.12 Extramural Activities and Sport I/We accept and agree that Pupils are encouraged to participate in at least one extramural activity offered by

Sans Souci throughout the year. All practices / matches / rehearsals / performances, etc. must be attended.

NO excuses will be accepted and, therefore, other arrangements should not be made during these times. If

the Pupil is ill, a Medical Certificate must be supplied.

All the necessary extramural uniform requirements will be met.

1.13 Uniform

I/We hereby accept that the Pupil may wear only the regulation school uniform, both at school and when in

uniform outside the school grounds.

This would cover both school and extramural dress code.

SIGNATURE : BIOLOGICAL PARENT/FOSTER/ADOPTED/LEGAL GUARDIAN (1) (Tick which one) ………………………………

SIGNATURE : BIOLOGICAL PARENT/FOSTER/ADOPTED/LEGAL GUARDIAN (2) (Tick which one) ……………………………...

1.14 N.B. Start of School Day, Attendance and Punctuality I/We hereby agree to be responsible and to ensure that the Pupil arrives at school well before the start of the

school day so as to ensure that she may line up outside the classroom in readiness for the first lesson. Other

arrangements, e.g. family matters and medical appointments, must NOT be arranged to take place during the

Academic day or when a Pupil has an Extramural activity.

___________________________________________________________________

2. PUPIL’S HEALTH 2.1 Pupil suffers from: (tick)

Blood Pressure [ ] Epilepsy [ ] Asthma [ ]

Diabetes [ ] Migraine [ ]

Allergy (specify): ................................................................. Other (specify):.........................................................

2.2 Any other physical difficulties:

.................................................................................................................................................................................

2.3 Operation(s) and date(s) the Pupil has had:

................................................................................................................................................................................. 2.4 Immunisation:

N.B. Pupils should have received all the compulsory immunisation as required by the State. Written evidence of Immunisation is required from a Pupil who is admitted to a Western Cape Education Department school.

2.5 Family Doctor/Clinic: .................................................................. Tel. No.:...........................................................

Cell No.:...........................................................

2.6 Name of emergency contact person (other than parent):..................................................................................

Relationship to Pupil:..........................................................................................................................................

Home Tel. No.: .................................. Work Tel. No.: ..................................... Cell No.:........................................

___________________________________________________________________

3. DETAILS OF BIOLOGICAL PARENTS / FOSTER / ADOPTED OR LEGAL GUARDIAN/S If there are two biological parents/foster/adopted or legal guardians, all are entitled to vote at an election of the School Governing Body. The information hereunder should therefore be given in respect of each biolgocial parent/foster/adopted or legal guardian. Certified copies of I.D. documents of both biological parents/foster/adopted or legal guardian/s MUST be attached.

N.B. If you are not the parent, papers regarding legal guardianship MUST be included.

3.1 Marital status of biological parent/foster/adopted or legal guardian: (tick)

Married [ ] Separated [ ] Unmarried [ ] Widow(er) [ ] Divorced [ ] Widow(er) and remarried [ ] Divorced and remarried [ ] 3.2 With whom does the Pupil live? (tick)

Mother and father [ ] Father and stepmother [ ] Mother [ ] Grandparent [ ] Father [ ] Legal Guardian [ ] Mother and stepfather [ ] Other (specify) .........................................................

3.3 Name(s) of person(s) to whom her report should be sent to:.......................................................................... 3.4 Employment status of biological parent/foster/adopted or legal guardian: (tick)

Both parents work [ ] Neither parent works [ ] Only father works [ ] Single parent, who works [ ] Only mother works [ ]



3.5 Financial status of biological parent/foster/adopted or legal guardian: [ please indicate YES or NO ] Normal ( salary/wages ) [ ______ ] Receive pension [ ______ ] Rec. maintenance from ex-husband [ ______ ] Receive welfare grant [ ______ ] 3.6 Person responsible for School Fees: tick Biological Mother [ ] Legal Guardian [ ] Biological Father [ ] Sponsor [ ] Foster parent [ ] Adopted [ ]

(N.B. Upon acceptance, a Contract must be signed by the Sponsor. Annexure C must also be signed and a letter stating that the Sponsor is responsible for the fees for the full duration of the pupil’s stay at Sans Souci.)

3.7 Method of payment of School Fees:

Annual School Fees are compulsory and are payable by Debit Order over a ten month period for Grade 8 to 12 (Jan – Oct each year). NB: The School Governing Body reserves the right to increase the fees at any time should the situation require this.

3.8 Other costs:

* Additional subject costs/ levies and excursions (entrance fees and transportation etc) * External competitions and eisteddfods etc. * Project Development Fund * Tablet and e-books and ICT fees * Additional consumables for subjects

3.9 BIOLOGICAL FATHER / FOSTER / ADOPTED / LEGAL GUARDIAN

Name & Surname:..................................................... Occupation: ……………………………..………............

I.D. no.: ........................................................... Name of Employer: .....................................................

Employee No.: …………………………………………..

Residential Address: Name of own Business: ……………………………

…………………………………………………….. Work/Business Address:

………………………………. Code: …………… …………………………………………………………….

……………………………………… Code: ……………

Tel. No.: ( ....... ) .......................... Ext.: ……… Tel. No.: (........) .................................. Ext.: .............

Cell No.: ......................................................... Cell No.: ...................................................................

E-mail Address: .............................................. Work E-mail Address: ...............................................

3.10 BIOLOGICAL MOTHER / FOSTER / ADOPTED / LEGAL GUARDIAN

Name & Surname: ....................................................... Occupation: ..............................................................

I.D. no.: .......................................................... Name of Employer: ..................................................

Employee No.: ………………………………………...

Residential Address: Name of own Business: ………………………....

…………………………………………………….. Work/Business Address:

………………………………… Code: …………. ………………………………………………………….… …………………………………………………………….

……………………………………… Code: ……….…..

Tel. No.: ( ....... ) ........................ Ext.: ………. Tel. No.: (........) ................................. Ext.: .............

Cell No.: ......................................................... Cell No.: ...................................................................

E-mail Address: .............................................. Work E-mail Address: ..............................................

___________________________________________________________________ The signatories below do hereby declare that the information which has been recorded in this form is true and correct and hereby give the Chairman of the School Governing Body, or his designate, permission to check and confirm any of the details or documents included in this Application. The signatories below understand that if any of the information supplied is found to be false, action may be taken against them.

SIGNATURES: (Please note that each page of this Application must be signed by both biological

parents/legal guardians)



DATE: ………………………………………………………..

ANNEXURE A

SANS SOUCI GIRLS’ HIGH SCHOOL

APPLICATION FOR ADMISSION

(Section A to be completed by Parent and then handed to the Pupil’s present Principal for completion of Section B) Dear Principal A Pupil from your school has applied for admission to Sans Souci. Kindly complete Section B of this assessment below as it forms part of the Application and is required for the interview. Please EMAIL ([email protected]) or FAX it directly to the school (fax no. 021 683 4090).

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

SECTION A Parent to complete this section before handing to the Principal.

NAME OF PUPIL: ................................................…………................................……….........................

PRESENT SCHOOL: .............................................………...…..................... GRADE: ................……….....

Contact numbers of Present School: Tel: (........) ..............……….......... Fax: (........) ...........……................

Contact numbers of Parents: Father: Tel: (........) ......……......…....... Mother: Tel: (.......) ....……................

Father: E-mail: .............................................. Mother: E-mail: ................................................

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

SECTION B

For completion by the Principal of the Present School.

1 : ACADEMIC

Does the Pupil’s academic performance reflect her capability? ( ) YES [ ] NO [ ]

This Pupil’s academic results fall into the [TOP] [MIDDLE] [BOTTOM] third of her Grade.

This Pupil has studied: English ( ) YES [ ] NO [ ]

Afrikaans ( ) YES [ ] NO [ ]

IsiXhosa ( ) YES [ ] NO [ ]

2 : SKILLS

Please rate the above-mentioned Pupil on the following scale:

5 = EXCELLENT 4 = GOOD 3 = AVERAGE 2 = WEAK 1 = VERY WEAK

WORK SKILLS SOCIAL SKILLS

Concentration Self-control

Independence Acceptance of responsibility

Listening skills Interaction with peers

Following instructions Group participation

Task completion Courtesy

Presentation of work Behaviour

Meeting deadlines Respect for superiors

Proficiency with English Appearance

Proficiency with Afrikaans Reliability

mailto:[email protected]

Proficiency with Mathematics Problem solving ability

Study habits Adherence to Code of Conduct

Reading ability Leadership skills

Please turn over

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3 : INVOLVEMENT IN SCHOOL LIFE Please rate the above-mentioned Pupil on the following scale: 5 = EXCELLENT 4 = GOOD 3 = AVERAGE 2 = WEAK 1 = VERY WEAK

Sport Societies Culture

Attendance at School

4 : GENERAL INFORMATION

Please rank the Pupil on the following scale: ( )

4.1 [ ] 5 Excellent: Would be a great asset to Sans Souci Girls’ High School.

[ ] 4 Very Good: Would be a definite asset to Sans Souci Girls’ High School.

[ ] 3 Good: Would be an asset to Sans Souci Girls’ High School.

[ ] 2 Average: Indifferent

[ ] 1 Would not really contribute much to or gain much from Sans Souci Girls’ High School.

4.2 Were the Pupil’s parents involved in and/or supportive of the school? ( ) YES [ ] NO [ ]

Please specify: ..................................................................................................................................

5 : DISCIPLINE

Has any disciplinary action been taken against the Pupil for the following offences? ( )

Disruptive in class Books left at home Swearing

Insolence Stealing Smoking

Work not done Dealing in/Taking drugs Bullying/Fighting

Gang-related activities Vandalism

Has the Pupil ever been suspended? ( ) YES [ ] NO [ ]

Has the Pupil been expelled? ( ) YES [ ] NO [ ]

Is there ANYTHING ELSE you feel we should know about the Pupil?

Thank you very much for completing this form.

PRINCIPAL’S NAME: ......................................................... SIGNATURE: ...............................................

DATE: ...................................................... SCHOOL STAMP: K: ANNEXURE A 2020 (February 2019)

ANNEXURE B

SANS SOUCI GIRLS’ HIGH SCHOOL


(To be completed by PUPIL herself)

1. Pupil’s Name:

……………………………………………………………………………………………………..

2. Present School:

...........................................…………………………..........................................................

3. Last Grade passed: ..................................................... Year passed:

..................................................…

4. Name of High School nearest to where you live:

.......................................................................................

5. How will you get to school if you come to SANS SOUCI GIRLS’ HIGH SCHOOL?

By walking / bicycle / car / bus / train / taxi (Please underline)

6. Name the types of SPORT and CULTURAL ACTIVITIES in which you participate AND state the

team/teams that you are in (if applicable):

......................................................................................................................................….......................

....

............................................................................................................................................….................

....

7. You are advised to apply to at least 3 schools: Please indicate the other Schools you are applying

to:

………………………………………………………………………….…………………………………………

….

8. Name any other forms of SPORT or ACTIVITIES, not taught at your school, in which you participate:

................................................................................................................................................................

....

................................................................................................................................................................

... 9. Give details (level and date - e.g. WP Colours) of any SPORT, ACADEMIC or CULTURAL achievements:

.................................................................................................... Date: .......................................

.................................................................................................... Date: .......................................

.................................................................................................... Date: .......................................

10. (Tick where appropriate):

10.1 Are you a: Class Captain? [ } Monitor? [ ]

House Captain? [ ] Prefect? [ ]

Sport Captain? [ ]

Other Leadership position/s: ............................................................................................................. 10.2 Do you belong to: Girl Guides? [ ] A Youth Club? [ ]

Red Cross or St. Johns? [ ] A Church Guild? [ ]

11. Hobbies and interests out of school; how free time is spent: ............................................................

…………………………………………………………………………………………………………………

…………………………………………………………………………………………………………………

12. Do you have a COMPUTER at home that you use? (Please tick) [ YES ] [ NO ]

Please turn over

-2-

13. Write a paragraph about yourself and your family:

...........................................................................................................................................................

...........................................................................................................................................................

...........................................................................................................................................................

...........................................................................................................................................................

...........................................................................................................................................................

...........................................................................................................................................................

14. Why would you like to come to SANS SOUCI GIRLS’ HIGH SCHOOL?

...........................................................................................................................................................

...........................................................................................................................................................

...........................................................................................................................................................

...........................................................................................................................................................

...........................................................................................................................................................

...........................................................................................................................................................

15. Is your mother a past pupil? (Please tick) [ YES ] [ NO ]

Is your sister a present / past pupil? (Please tick) [ YES ] [ NO ]

16. Do you have lessons after school in: (Please underline)

Ballet / Dance / Art / Any School Subjects

Provide details here: .........................................................................................................................

...........................................................................................................................................................

...........................................................................................................................................................

17. MUSIC lessons (if applicable): Details of lessons already taken:

17.1 Instrument/s: ....………………………………………………………………………………………………

17.2 Number of years of study: .................................................................................................................

17.3 Level reached: .................................................................................................................................

17.4 Whether studied at school or privately: .............................................................................................

17.5 Name of Teacher: ...........................................................................................................................

17.6 Do you have a piano at home? .........................................................................................................

PUPIL’S SIGNATURE: .................................................................................................................................

BIOLOGICAL PARENT’S/FOSTER/ADOPTIVE/LEGALGUARDIAN

SIGNATURE:…………………………….. RELATIONSHIP: ....................…..............................................

DATE: …………………………………….

K: ANNEXURE B 2020 (February 2019)

SANS SOUCI GIRLS’ HIGH SCHOOL ANNEXURE C


(To be completed by both biological parents / foster / adoptive / legal guardians / sponsors)

UNDERTAKING BY BIOLOGICAL PARENTS/FOSTER/ADOPTED/LEGAL GUARDIANS SHOULD YOUR DAUGHTER BE ACCEPTED AS A PUPIL AT SANS SOUCI GIRLS’ HIGH SCHOOL

This undertaking is made to ensure that the school is able to have the necessary support to allow my/our daughter to have the best

opportunity to achieve her potential, if she is accepted.

N.B. Details of Fee Sponsor, if applicable:-

Full names: ................................................................................................................. .............................

Address: ............................................................................................................... Postal code: ..............

Contact no’s: Land-line: ..................................................... Cell no.: ...................................................

1. I/We hereby confirm that the above details are correct and that the Sponsor has been informed that he/she will be responsible

for the fees for the full duration of the pupil’s stay at Sans Souci. A letter stating this is required from the sponsor and must

accompany this Application.

2. I/We hereby apply to have the child whose name appears on this Application Form as a Pupil at Sans Souci Girls’ High School

and confirm that she complies with the basic criteria.

3. I/We hereby certify that I/we have legal custody and/or guardianship in respect of the above-named Pupil.

4. I/We undertake to adhere to the School Rules and Code OF Conduct (Discipline, Behaviour and Dress) and to the various

alterations in the Rules and Disciplinary Code that may be made from time to time.

5. I/We understand and confirm that the Principal or any person duly authorised, will act in loco parentis in any matter and at any

time during which I/we have entrusted my/our child to the care of the school.

6. I/We understand that while every reasonable effort will be made to prevent losses or damage to a Pupil’s clothing and

equipment, the school cannot be held liable for such.

7. I/We undertake to reimburse the school for any damage to school property that may be caused by my/our child.

8. I/We jointly and severally undertake to pay school fees and I/we understand the following:

a. The annual school fees will be an annual compulsory sum of money adopted by the majority of parents at the AGM

Budget Meeting.

b. This fee may be paid off in 10 monthly instalments for Grade 8-12 (Jan to Oct)

c. Public school fees are a statutory obligation in terms of the South African Schools Act No 84 of 1996 (as amended

and hereafter referred to as the Schools Act) and in terms of Section 39 of the Schools Act, the parties to this form are

liable to pay compulsory School Fees.

d. In terms of Section 40 of the South African Schools Act, the school may enforce the payment of these compulsory

fees.

e. The parties to this application undertake to pay all legal costs, including attorney/client fees and collection costs, incurred by the school in the event of the school having to take legal action for the recovery of school fees.

f. School fees are payable annually in advance at the beginning of each school year and such payment is compulsory unless I/we have been granted an exemption or partial exemption. However, purely in order to reduce the financial burden on parents, the school may extend the terms of payable completely at its discretion. Should the School grant me/us such an indulgence, I/we accept that this undertaking in no way changes the fact that the payment of school fees is a statutory duty and not a voluntary agreement, particularly not a credit agreement as defined in terms of the National Credit Act No.34 of 2005.

g. If the School allows me/us any form of extended payment and I/we default and fail to pay any single instalments by

the due date, then the whole amount that is outstanding will become immediately due and payable.

h. I/we authorise the school to do credit bureaux searches on me/us and in the event of any school fees due by me/us not

being paid, I/we authorize the school to inform any relevant credit bureau and have my/our name listed with them

i. That in the event that I/we am/are not the biological parent and/or foster parent and/or adopted parent or legal

guardian of the child/ren, then I/we accept responsibility of parent as defined in Section 1 of the Schools Act. Parents

who are unable to pay school fees may apply for a partial/full exemption of these fees.

9. I/We undertake to give notice in writing of any intention to remove my/our child from the school and furthermore to return any

books and/or equipment belonging to the school which my/our child may have.

10. I/We agree that my/our child be permitted to undertake group Edumetric and Psychometric tests which have been approved by

the Director of Education.

11. I/We agree that if my/our child is over the compulsory school-going age (15 years) she will attend school regularly and will

only be absent for medical reasons.

. 2/...

12. I/We understand that the school reserves the right to verify all information supplied to them via the biological

parent/foster/adopted or legal guardian. In the event of fraudulent documents/information being submitted, the school reserves

the right to lay a criminal charge of fraud against any of the responsible parties.

13. I/We accept the responsibility of my/our child’s transport to and from the school.

14. I/We undertake to inform the Principal of my/our child’s absence from school. Biological parents/foster/adopted or Legal

guardians declare that they are prepared to produce a doctor’s certificate if and when required.

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 non-adherence of the Code of Conduct (including Social Media), Bullying and Substance Abuse & Anti-

Violence Policies will not, under any circumstances, be tolerated.

17. The signatories hereto hereby choose domicillium citandi et executandi as indicated below. In the event of a change of address,

biological parents/foster/adopted or legal guardians are to notify the school in writing.

18. This commitment in its entirety will be valid from the day on which it is signed by the biological parent/foster/adopted or legal

guardian to the day on which the Pupil officially leaves the school.

19. I/We undertake to give two months’ notice in writing of any intention to remove my/our child from the school. I/We accept

financial liability for the notice months. I/We undertake to return any books and/or equipment belonging to the school which

my/our child may have. I/We understand that I/we are liable for payment for this notice period whether my/our daughter

attends the school or not, as well as for any outstanding school property.

The biological parent/foster/adopted or legal guardian declares that he/she is the legal guardian of the child and is entitled to sign this document, and shall be bound hereto both as biological parent/foster/adopted or legal guardian, and in his/her personal capacity. Biological Parent/Foster/Adopted/ Legal Guardian (Parent one, tick option):

Full name: ............................................................................................................

Address: (The signatory hereto hereby chooses domicillium citandi et executandi (official address) as:

……………………………………………………………............................................................................................

……………………………………………………………............................................... Postal Code: ………….....

Biological Parent/Foster/Adopted/Legal Guardian (Parent two, tick option):

Full name: ............................................................................................................

Address: (The signatory hereto hereby chooses domicillium citandi et executandi (official address) as:

……………………………………………………………............................................................................................

……………………………………………………………............................................... Postal Code: ………….....

DECLARATION : BIOLOGICAL PARENT/FOSTER/ADOPTED/LEGAL GUARDIAN (Parent one, tick option)

I ………………………………………………………………………… (print full name) hereby declare that the information which

I have recorded in this form is true and correct and by my signature below, I give the Chairman of the School Governing Body, or

his designate, permission to check and confirm any of the details listed by me, if this is deemed necessary. I understand that if any

of the information supplied by me is found to be false, action may be taken against me as in point 11 above.

Signed on this ………... day of …………….................... 20 …..... SIGNATURE: .………………………….......

DECLARATION : BIOLOGICAL PARENT/FOSTER/ADOPTED/LEGAL GUARDIAN (Parent two, tick option)

I …………………………………………………………………………… (print full name) hereby declare that the information

which I have recorded in this form is true and correct and by my signature below, I give the Chairman of the School Governing

Body, or his designate, permission to check and confirm any of the details listed by me, if this is deemed necessary. I understand

that if any of the information supplied by me is found to be false, action may be taken against me as in point 11 above.

Signed on this ………... day of …………….................... 20 …..... SIGNATURE: .………………………….......

K: ANNEXURE C 2020 (February 2019).