Registration form
Student details......
Name:
Surname:
COURSE: ………………..
Registration Fee paid:
R
ID No:
International students only
Passport No:
HOD NAME and SURNAME ....................................................................................................................
HOD SIGNATURE....................................................................
,
OFFICE USE ONLY……………… Mark with X
CLASS GROUP:
FULL TIME:
TIME PERIOD:
PART TIME:
SUPPLEMENTARY:
Student Number:
Course:
Campus Name:
Study Direction:
Disability:
Y
N Type of Disability:
Subjects (PLEASE COMPLETE)
Fees
Level
Subject Code
F/P/S
Period
Male
Female
STUDENT PERSONAL DETAILS
Title:
Surname:
Initials:
First Names:
Gender:
ID Number:
D D
Date of Birth:
Ethnicity:
M
African:
M
Y
Asian:
Y
Y
Y
coloured:
Marital Status
Indian:
White:
other:
INTERNATIONAL STUDENTS ONLY
Study Permit : Y
N
Permit Expiry Date: D
Passport No:
D
M
M
Y
Y
Y
Home Language:
Y Passport Expiry Date: D D
Year Passed:
Transport:
Accommodation:
STUDENT CONTACT DETAILS
Telephone No H:
Cell phone No:
E-mail:
Residential Address:
M
Y
Y
Y Y
Y
Y
Y
Exam Language:
Highest Qualification:
Car Registration:
M
Work No:
Y
Postal Code
FINANCIAL CONTACT DETAILS
BURSARY HOLDER: Y
N
Name of person or company:
Telephone No H:
Work No:
Cell phone No:
E-mail:
Residential Address:
Postal Code:
ACADEMICAL CONTACT DETAILS
Name of person or company:
Telephone No H:
Work No:
Cell phone No:
E-mail:
Residential Address:
Postal Code:
NEXT OF KIN CONTACT DETAILS
Name:
Surname:
Telephone No H:
Work No:
Cell phone No:
E-mail:
Residential Address:
Postal Code:
Please read this carefully before signing.
I the applicant hereby:
(a) Declare that all information in this document is true and correct;
(b) Undertake to familiarize myself with all rules, policies and procedures of the Motheo TVET Collage
(c) Undertake that for the duration of my period of study I commit myself to complying with all rules, policies and procedures laid down by
Motheo TVET Collage
I acknowledge that I have read this document, understand its contents and agree to its terms and conditions. I further acknowledge that I am
signing this agreement voluntarily and not under duress
Signature of parent/guardian:
………………………………….. Date
D
D
- M
M
-
Y
Y
Y
Y
Signature of Student:
…………… ……………………
D
D
- M
M
-
Y
Y
Y
Y
Date