REGISTRATION/ADMITTANCE FORM

To ensure the smooth running of Window 2 Learning and to rule out any uncertainty, PLEASE:
1. Read
2. Complete
3. Attach certified copies of the following documents along with the Registration/Admittance form
4.1 Father / Stepfather/ Legal Guardian ID Document
4.2 Mom / Stepmother / Legal Guardian ID Document
4.3 Emergency Contact ID
4.4 Birth Certificate of Learner
4.5 Most recent School Report of Learner
4.6 Medical Aid Card
5. 2 Coloured ID Photos of learner
6. Copy of Vaccination Record of Learner

Name and Surname of Learner

Date of Birth*

ID Number*

Age*

Gender*

Male

Female

Home language

Other language/s*

Number of Children in Family*

Position of child in family*

Religion*

Address*

Postal Address

Phone*

PARENTS/GUARDIANS INFORMATION

DETAILS OF FATHER/STEPFATHER/GUARDIAN

Name*

ID Number*

Cellphone Number*

Work number*

Relationship to child*

Employer*

Address*

DETAILS OF MOTHER/STEPMOTHER/GUARDIAN

Name*

ID Number*

Cellphone Number*

Work number*

Relationship to child*

Employer*

Address*

DECLARATION OF PARENTS / LEGAL GUARDIANS

We, the undersigned, hereby certify that the information given by us in this Registration/Admittance form is complete and accurate. We also agree on the conditions as set out herein.

This application form will be reconsidered in the case where important relevant information, which should be brought to the attention of Window 2Learning management, is withheld.

We agree

Name

EMERGENCY CONTACT INFORMATION

(other than Mother or Father or Guardian)

Name

ID Number*

Relationship to child*

Cellphone Number*

Work number*

ACCOUNT HOLDER INFORMATION

Name

ID Number*

Relationship to child*

Cellphone Number*

Work number*

Address*

Postal Address*

DECLARATION OF ACCOUNT HOLDER

I, the undersigned, hereby certify that the information given of the Account Holder in this Registration/Admittance form is complete and accurate.

I accept joint and several liability to Window 2 Learning for the due and punctual payment of fees and any other amount which may become due.

Name

I agree

LEARNER’S EDUCATIONAL DETAILS

Current/Previous School*

Address of School

Tel No*

Principal*

Has admission to any other School/s ever been refused?*

Yes

If Yes, please state reason.

LEARNERS MEDICAL DETAILS

Medical Aid Name

Medical Aid Number

Main Member ID Number

Dependant Code of Learner

Option/Plan

Has the learner received all the necessary immunisations?*

Yes

If No, please state reason.

Does the learner have any Allergies or Special medical needs

Any Additional Comments

Uploads

Attach certified copies of the following documents

Father / Stepfather/ Legal Guardian ID Document

Emergency Contact ID

Most recent School Report of Learner

Copy of Vaccination Record of Learner

Birth Certificate of Learner

Mom / Stepmother / Legal Guardian ID Document

Medical Aid Card

Coloured ID Photos of learner

Window 2 Learning Excellence

REGISTRATION/ADMITTANCE FORM

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