JBAY ACADEMY Grade R-3 Application Form 2016 LEARNER NAME:__________________________ GRADE: _________________________________

LEARNERS MEDICAL INFORMATION APPLICATION FOR 2016 NAME OF LEARNER: GRADE APPLYING FOR: CURRENT SCHOOL: LEARNERS MEDICAL INFORMATION MEDICAL AID: MEDICAL AID NO: MAIN MEMBER: NAME OF GP: GP TEL: ALLERGIES: IMMUNISATION: SPECIAL MEDICAL PROBLEMS REQUIRING COUNSELLING:

LEARNER DETAIL OTHER DETAIL FULL NAME AND SURNAME: DATE OF BIRTH: HOME LANGUAGE: HOME ADDRESS: PLACE OF CHILD IN THE FAMILY (1ST, 2ND, 3RD CHILD): OTHER DETAIL PLEASE INDICATE ANY APPROPRIATE INFORMATION IN THE FOLLOWING AREAS PHYSICAL DISABILITIES: LEARNING DISABILITIES: SOCIAL DISABILITIES:

OTHER DETAIL MOTHER NAME: WORK ADDRESS: WORK TEL: CELL: EMAIL: FATHER NAME: WORK ADDRESS: WORK TEL: CELL: EMAIL: EMERGENCY CONTACT (OTHER THAN PARENTS): WHO WILL COLLECT THE CHILD AT THE SCHOOL: TEL:

SCHOOL FEES Who will be responsible for the school fees: Payment method School fees are payable in advance by the 1st and not later than the 7th of each month. The parents must be aware that the school fees are payable in 11 Months. Parents are jointly liable for the payments of the school fees. In event of the parents being in default of payment of the school fees-interest at the rate of 20% per annum will be levied on all such amounts which are due as calculated from the date upon which it became payable. Legal steps will be instituted against them without prior notification for the recovery of such arrear fees in which event the parents will be liable for all legal costs and expenses as between attorney and own client including such collection commission which may lawfully become due . Cancellation – 2 months notice . Banking details: Jbay Academy Standard Bank Branch code: 050315 Account: 252461398 Reference: Student name and grade 9. The school fees include the curriculum plus school fees for the year. Payments are calculated over 11 months. FEES FOR 2016 Non refundable registration fee of R550-00 payable on submission of Application. Monthly School fees - R1 500 per month for 1 child - R1 300 per month for every child more than one. Half year payment in advance / 2% discount – R 8 820 Full year payment in advance / 5% discount – R 15 670 Aftercare: R500 per month for 1 child R350 per month for every child more than one. CASH DEBIT EFT

PLEASE ATTACH THE FOLLOWING WITH EVERY APPLICATION (School to complete the tick box below) Copy of most recent school report Copy of any professional reports Copy of unabridged birth certificate Proof of payment for: - Registration fee RESPONSIBILTIES OF PARENT & LEARNERS LEARNER MUST BEHAVE IN ORDERLY MANNER MUST ACCEPT DISCIPLINE WHICH IS NECESSARY FOR THE GOOD FUNCTIONING OF THE ACADEMY MUST ATTEND ACADEMY FAITHFULLY NAME OF PARENT NAME OF PARENT __________________ ___________________ SIGNATURE PARENT SIGNATURE PARENT DATE: ______________ JBAY ACADEMY ___________________________