1. “GEARED TO GO FULL CIRCLE”
CAMPUS
KRIEL COLLEGE
REGISTRATION 2017
BETHAL COLLEGE
BELFAST COLLEGE
“GEARED TO GO FULL CIRCLE”
BELFAST AGRI COLLEGE
STUDENT NUMBER
(FOR OFFICE USE ONLY)
Please complete the entire form in print.
Mark with an X where applicable.
Enrolment Date
STUDENT INFORMATION
ID Number
DATE OF BIRTH :
TITLE MR MS
OTHER
GENDER: MALE FEMALE
RACE
WHITE
COLOURED
INDIAN
AFRICAN
HOME LANGUAGE
SURNAME:
INITIALS:
FULL NAMES:
CELL:
PHYSICAL ADDRESS:
TEL:
CODE:
OTHER CONTACT
PROVINCE

2. STUDENT PARENTAL INFORMATION
FATHER MOTHER
SURNAME:
FULL NAMES:
ID NUMBER
HOME:
CELL:
NEXT OF KIN (NEXT OF KIN IN CASE OF EMERGENCY)
NAME AND SURNAME:
CONTACT NUMBER:
INFORMATION OF PERSON(S) RESPONSIBLE FOR PAYMENT OF ACCOUNT
WHO IS RESPONSIBLE FOR YOUR STUDY FEES
PARENT(S)
STUDENT
EMPLOYER
GUARDIAN
TRUST
BURSURY
CONTACT DETAILS OF PERSON RESPONSIBLE FOR YOUR STUDY FEES:
INITIALS & SURNAME:
CONTACT NUMBER:
POSTAL ADDRESS

3. ACADEMIC HISTORY WWW.CIRCLEWAYCOLLEGE.CO.ZA
NAME OF LAST SCHOOL ATTENDED:
DATE OF FINAL SCHOOL YEAR
HIGHEST GRADE PASSED
COURSE SELECTION
FULL TIME: PARTIME:
COURSE TAKEN:
TRIMESTER 1
TRIMESTER 2
TRIMESTER 3
SUBJECT (S) EXAM
SITTING
SUBJECT (S) EXAM
SUBJECT (S) EXAM

4. Declaration by applicant (This section is compulsory)
CONDITIONS OF ENROLMENT
1. An applicant is accepted into any programme if he/she satisfy the minimum requirements of a programme.
2. Registration is not complete until all the fees required are paid up.
3. All fees paid as Registration Fees / Deposit are strictly not refundable.
4. The registration form should be accompanied by all relevant documentation
Certified Identity document or Passport with valid visa for non South Africans
Certified previous qualifications
Certified proof of residence
Valid proof of banking applicable to bursary students
Updated Curriculum Vita
5. Read carefully and understand all the clauses of this application form before endorsing your signature.
6. All the information supplied to the college is in utmost good faith. The college reserves the right to cancel any application if the information supplied is false and if there are omissions meant to mislead College authorities.
Declaration by applicant
(This section is compulsory)
I, the undersigned, accept and acknowledge the following clauses as part of Circleway College Policy.
Paying Fees and Refunds
I understand that as a student of the college I must comply with the requirements for student contribution tuition fees and any other fees as applicable, by the 4th of the month. Any fees not paid by the 4th day of the month attract 10% interest, and if the total outstanding fees for the current month is not paid by the 7th day of the month I will be excluded from classes. I also agree that all monies paid by me or my Sponsor to Circleway are non-refundable.
I understand that if for any reason I drop out of the college, I will owe the College the entire duration of this contract and that the College will legally claim the outstanding fees against me or my sponsor.
Exam Registration
I understand that it is my responsibility to fill out a DHET examination form for the examination and that i have been told of the closing date for examination registrations.
I understand that the college will not accept any late registration for examinations
I understand that the College reserves the right to prohibit me from sitting for examination should there be any outstanding funds that have not been paid.
I understand that I will sit a control & block test that will contribute to my final mark and that it is my responsibility to avail myself for these tests.
Full Names: Surname:
Signed at: on the of
Signature:
Initials and Surname:
Date:
SIGN HERE APPLICANT
OFFICE USE ONLY
Application Processed by
OFFICIAL STAMP

5. Circleway training Engineering Business Studies ICASS – MARK
Stand 3 Section 1 Heinrich Street Kriel 2271
017  or 084 
Postnet Suite #45 P Bag X 1036 Bethal 2310
UmalusiReg: PA, 00912PA, 00913PA, 00915PA Teta-12/231
Addendum to Registration Contract
ICASS – MARK
Engineering
You are hereby informed that:
Your ICASS-Mark consist of:
30% of your Test 1 (Controlled Test) marks and
70% of your Test 2 (Block Test) marks
Business Studies
20% of an assignment mark.
30% of Test 1 (Controlled Test) marks.
50% of Test 2 (Block Test) marks.
Take note that if you are a full-time or part-time (not attending) student the above ruling will apply.
Student Q+A Manager
16570