HOLY CROSS HIGH SCHOOL

Transcription

1 HOLY CROSS HIGH SCHOOL PHOTO 161 Coronation Road Maitland 7405 Tel: Fax: IN CRUCE SALUS PBO NO: WCED REG NO: PUPIL INFORMATION (PLEASE PRINT) APPLICATION FOR ADMISSION SURNAME: FIRST NAME/S :... DATE OF BIRTH: I.D No/PASSPORT:HOME LANGUAGE: PLACE OF B IRTH: RELIGION...BAPTISM FIRST COMMUNION:... CONFIRMATION:... YEAR APPLIED FOR TERM APPLIED FOR GRADE APPLIED FOR IF CATHOLIC TO WHICH PARISH DO YOU BELONG TO NAME AND ADDRESS OF PRESENT SCHOOL: TEL:No.: PRESENT CLASS: WHERE DID YOU HEAR ABOUT OUR SCHOOL?... PARENT INFORMATION MOTHER: FIRST NAME/S:. TITLE (Mrs/Dr/Prof. etc.)... FATHER FIRST NAME/S: TITLE (Mrs/Dr/Prof/.etc.) SURNAME:.. HOME ADDRESS. CODE:.. OCCUPATION:.. I.D. NUMBER:.. MARITAL STATUS:. POSTAL ADDRESS: EMPLOYER NAME: EMPLOYER ADDRESS:. CODE: HOME TELEPHONE: WORK CELLPHONE: .. SURNAME:.. HOME ADDRESS:.....CODE:.. OCCUPATION:.. I.D NUMBER: MARITAL STATUS:... POSTAL ADDRESS: EMPLOYER NAME: EMPLOYER ADDRESS: CODE: HOME TELEPHONE: WORK: CELLPHONE:

2 FAMILY CONNECTIONS NUMBER OF CHILDREN IN FAMILY. POSITION IN FAMILY 1 ST, 2 ND ARE ANY SIBLINGS OR FAMILY MEMBERS ALREADY IN HOLY CROSS? (Y/N). IF SO, STATE WHETHER SISTER, COUSIN, ECT WHEN?... REFERENCES (NAMES OF TWO REFEREES CONTACTABLE IN CASE OF EMERGENCY) NAME: NAME: TEL NO:.. TEL NO:. I/ WE CERTIFY THAT ALL THE INFORMATION PROVIDED ON THIS APPLICATION FROM IS CORRECT. SIGNED: (FATHER) SIGNED: (MOTHER) DATE: DATE:.. WITHDRAWAL OF LEARNER: WE REQUIRE A FULL TERM S NOTICE IN WRITING, UPON WITHDRAWAL OF A LEARNER FROM THE SCHOOL. FAILURE TO DO SO WILL RESULT IN PAYMENT OF A FULL TERM S FEES IN LIEU OF NOTICE. THIS IS IN ACCORDANCE WITH SCHOOL POLICY AND WILL NOT BE WAIVED UNDER ANY CIRCUMSTANCES. OFFICE USE ONLY ISSUED REGISTRATION DATE: RETURNED REG. RECEIPT NO. REGISTERED BY DOCUMENTS REQUIRED UPON REGISTRATION: CERTIFIED COPIES OF PARENT S /GUARDIAN S ID DOCUMENTS CERTIFIED COPY OF LEARNER S BIRTH CERTIFICATE IMMIGRANT S RESIDENCE PERMIT OR PROOF OF CURRENT REFUGEE STATUS PROOF OF ADDRESS-MUNICIPAL, TELEPHONE OR RETAIL ACCOUNT PROOF OF INCOME: COPY OF PAYSLIP OR BANK STATEMENT MOST RECENT SCHOOL REPORT ID SIZE PHOTO OF LEARNER N.B ONCE LEARNER HAS BEEN ACCEPTED TRANSFER LETTER AND RECENT REPORT NEED TO BE ACCOMPANIED.

3 IF PARENTS ARE DIVORCED /SEPERATED (PLEASE TICK WHERE APPROPIATE): PERSON(S) WITH WHOM APPLICANT LIVES: PERSON(S) RESPONSIBLE FOR SCHOOL FEES: PERSON(S) TO WHOM CORRESPONDENCE SHOULD BE SENT: PERSON(S) TO WHOM REPORTS SHOULD BE SENT: MONTHLY FAMILY INCOME (TICK WHERE APPROPIATE) o BELOW R4 000 o R R6 000 o R R8 000 o R R o R R o ABOVE R IF THE LEARNER IS ON A BURSARY OF IF FEES ARE PAID THROUGH A TRUST FUND, PLEASE COMPLETE: NAME OF INSTITIUTE OR TRUST FUND ADDRESS OF INSTITUTE OR TRUST FUND CONTACT PERSON:. TEL NO:. MEDICAL HISTORY: MEDICAL CONDITIONS THE SCHOOL NEEDS TO BE AWARE OF... NAME OF MEDICAL AID MEDICAL AID NUMBER PRINCIPLE MEMBER NAME OF FAMILY DOCTOR CONTACT NO

4 HOLY CROSS HIGH SCHOOL 161 Coronation Road Maitland 7405 Tel: Fax: TO BE COMPLETED BY LEARNER S CURRENT SCHOOL DEAR Sir/ Madam IN CRUCE SALUS admin@holycrosshigh.co.za bursar@holycrosshigh.co.za PBO NO: WCED REG NO: A learner from your school has applied to HOLY CROSS HIGH SCHOOL. Would you please be so kind as to complete the assessment below and fax it to us at in order for us to process this application NAME OF LEARNER GRADE:.. CEMIS NUMBER.. CURRENT SCHOOL:.. CONTACT NO OF SCHOOL: TEL.. FAX:.. Does the learner s academic performance reflect her capability? YES NO Her academic results fall into TOP MIDDLE BOTTOM third of her grade Is this an LSEN learner YES NO Were the parents involved in and/or supportive of the school? YES NO What are your annual fees?. Are fees currently up to date? YES NO If no, outstanding balance.. Have you experiences difficulties with school fee collection? YES NO INDICATE ABILITY ON A SCALE OF 1-5 ALONGSIDE EACH OF THE FOLLOWING: 5= EXCELLENT 4= GOOD 3= AVERAGE 2=WEAK 1=-VERY WEAK WORK SKILLS... CONCENTRATION INDEPENDENCE LISTENING SKILLS. FOLLOWING INSTRUCTIONS.. TASK COMPLETION. PRESENTATION OF WORK MEETING DEADLINES. FACILITY OF ENGLISH. READING ABILITY. SOCIAL SKILLS SELF CONTROL. ACCEPTANCE OF RESPONSIBILTY. INTERACTION WITH PEERS. GROUP PARTICIPATION. COURTESY BEHAVIOUR. RESPECT OF SUPERIOURS.. APPEARANCE LEADERSHIP SKILLS. SCHOOL STAMP WOULD YOU RECOMMEND THIS LEARNER YES NO COMPLETED BY: NAME: SIGNATURE: DESIGNATION: DATE:

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