Imbila Education (PTY) Ltd
Registration Form 2015 – N1-N6
Student no
PARENT PARTICULARS:
Support Centre
Surname
Full Names
Name known by
Identity Number
Relationship
Postal Address:
Residential Address:
Work Tel
-
-
Cell phone
-
-
Home Tel
-
-
-
Ext
E-mail
Preferred
communication
Email
Sms
Cell
Land Line
Other
STUDENT PARTICULARS:
Surname
Full Names
Name known by
Identity Number
Gender
Cell phone
-
-
Home Tel
-
-
M
F
E-mail
ACADEMIC INFORMATION:
Did you pass grade9 / NCA test: _______________________________________ (Please attach certified copy)
N course applying for? _______________________________________________
N Subjects: Refer to list of subjects for 2015 on page 4
1.__________________________
2.__________________________3.__________________________
4.__________________________
5.__________________________6.__________________________
7.__________________________
8.__________________________9.__________________________
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BANKING DETAILS:
Bank :
Account name:
Account number:
Branch code:
Branch:
FNB
Imbila Education (PTY) LTD
624 954 94587
252 445
Menlyn Square
CONTACT DETAILS:
Marketing & Registrations:
Finance:
Neels – 084 506 5233 / neels.beyers@imbila.co.za
Francois – 072 629 9725 / 012 804 9160 / francois@imbila.co.za
Fee structure (cash only):
N1
R1,900.00 per subject
N2
R1900.00 per subject
N3
R1,900.00 per subject
N4
R1,900.00 per subject
N5
R1,900.00 per subject
N6
R1,900.00 per subject
TEXT BOOKS:
All text books are included in the package.
UNDERTAKING BY THE PARENT/GUARDIAN
I declare that I/my child have/has completed the form in full and that the details are true and correct and
I undertake to inform you of any changes therein, immediately.
I, the undersigned, am responsible for the prompt payment of all and any money payable to Imbila
Education.
I, the undersigned, understand and agree that, once I have enrolled a learner/student at Imbila Education
for a specific year and therefor received the year’s product, I am responsible for the payment thereof
( You have 7 seven days to cancel the contract after receiving the product). There after No refund will
be given.
I understand that Imbila Education will at all times be entitled to summarily cancel this registration should
it become apparent that the information supplied on this form is false or incorrect. I further
understand that Imbila Education reserves the right to cancel a student’s admission/registration in
the event that the student was for any reason erroneously admitted to a qualification.
I understand that this undertaking signed by me specifically refers to my child’s application for admission
to Imbila Education and continuation of studies at Imbila Education.
I hereby bind myself jointly and severally and in whole together with the student to properly meet all
conditions contained herein.
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These conditions will remain valid and in force for the full duration of my/the student’s enrolment as a
student at Imbila Education and thereafter until all commitments in terms hereof have been met.
In the event of extra classes and/or examination at Imbila Education facilities/computer facilities:

The student binds themselves to the rules for the use of Imbila Education computer facilities and
accepts responsibility for electronic mail and Internet access.

I understand that Imbila Education will take all reasonable steps to prevent students from being
injured or prejudiced for any injury or damage, whether or not it is caused by the negligence of Imbila
Education or any of its employees, or a fellow-student, and I undertake not to institute any claims
against Imbila Education in respect of such an injury or damage. I further undertake to indemnify
Imbila Education should Imbila Education incur any liability whatsoever pursuant to any negligent or
other act or omission by me/the student.

I /the student, my/his/her dependants, executors, administrators, and/or transferees hereby
relinquish and indemnify Imbila Education against any claim or damage of whatsoever nature which
may arise at or outside the premises of Imbila Education during my/the student’s period of study at
Imbila Education.
Pretoria shall be regarded as the place where this agreement has come into existence, regardless of
where it may have been signed.
The contents of this agreement form the basis of the financial agreement between Imbila Education and
myself, including any amendment thereto.
Signed on this __________ day of ________________________________________ 20_____
____________________________________
____________________________________
Signature: parent/guardian/student (older than 18)
Signature: Person liable for payment
Name & surname: ____________________
Name & Surname: _____________________
Id: _________________________________
Id: __________________________________
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DOCUMENTATION: Please provide copies of





ID of student
ID of both parents
Proof of residence (FICA)
Report of grade 9 report or NCA test results
Proof of payment
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Closing period over December holidays:
Marketing & Registrations; Finance & Academy:
Closes 15 December 2014 – opening 5 January 2015
Although the offices close for this period, you are welcome to send registration forms with proof of payment.
As soon as we open again, these registrations will be processed first.
Email completed form (not page 5 & 6 please) & documents to:
registrasie@imbila.co.za
Please confirm receipt telephonically, 2-3 days after sending.
For more information, contact Neels 084 506 5233.
N1 – N6
Electrical Engineering – Heavy Current:
SUBJECTS
N1
N2
N3
N4
N5
N6
Mathematics
*
*
*
*
*
*
Industrial Electronics
*
*
*
*
*
*
Engineering Science / Physics
*
*
*
*
*
*
Electrical Trade Theory
*
*
Electro technics
*
*
*
Digital Electronics
*
*
*
Fault Finding
*
*
*
Supervisory Management
*
*
*
Electro technology
Refrigeration
*
*
*
*
Electrical Engineering – Light Current:
SUBJECTS
N1
N2
N3
N4
N5
N6
Mathematics
*
*
*
*
*
*
Industrial Electronics
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
*
Logic System
Radio and TV Theory
Instrument Trade Theory
Digital Electronics
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Communication Electronics
*
*
*
Computer Principles
*
*
*
Industrial Instruments
*
*
*
Supervisory Management
*
*
*
SUBJECTS
N1
N2
N3
Motor Trade Theory
*
*
*
*
*
Motor & Diesel:
Diesel Trade Theory
Motor Electrical
*
*
*
Mathematics
*
*
*
Industrial Electronics
*
*
*
Engineering Science
*
*
*
SUBJECTS
N1
N2
N3
Mathematics
*
*
*
Engineering Science
*
*
*
Engineering Drawing
*
*
*
Fitting & Machining
*
*
Fitting and Turning:
Mechanotechnology
*
Boiler making / Welding:
SUBJECTS
N1
N2
N3
Mathematics
*
*
*
Engineering Science
*
*
*
Plating & Structural Steel Drawing
*
*
*
Metal Works Theory
*
Boiler Making
*
Welding
*
Mechanotechnology
*
Millwright:
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SUBJECTS
N1
N2
N3
Mathematics
*
*
*
Engineering Science
*
*
*
Engineering Drawing
*
*
Electrical Trade Theory
*
*
Mechanotechnology
*
Mechanical Engineering (N4-N6)
N4
N5
N6
Mathematics
*
*
*
Engineering Science / Physics
*
*
*
Mechanotechnics
*
*
*
Mechanical Drawing
*
*
*
*
*
Power Machines
*
*
Strength of Materials & Structures
*
*
Fluid Mechanics
*
*
Mechanical Drawing & Design
Supervisory Management
*
Control Systems
*
Civil Engineering
SUBJECTS
N1
N2
N3
N4
N5
N6
Mathematics
*
*
*
Engineering Science
*
*
*
Building Drawing
*
*
*
Plumbing Theory
*
*
Building Administration
*
*
*
Quantity Surveying
*
*
*
Building & Structural Construction
*
*
*
Building & Structural Surveying
*
*
*
Building & Civil Technology
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Supervisory Management
*
*
*
N1
N2
N3
Additional Engineering Subjects
Supervision in Industry
*
Industrial Orientation
*
Industrial Organization & Planning
*
Cost:
All subjects are R1, 900.00 per subject.
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