PARENT PARTICULARS:
Surname
Student no
Support Centre
Full Names
Name known by
Identity Number Relationship
Postal Address:
Residential Address:
Work Tel - - Ext
Cell phone
Home Tel
E-mail
-
-
-
Preferred communication
Email Sms Cell Land Line Other
STUDENT PARTICULARS:
Surname
Full Names
Name known by
Identity Number Gender M F
Cell phone
Home Tel
-
-
E-mail
SBA PAYMENT OPTION (Refer to Fee Structure - p 2)
Full payment
ACADEMIC INFORMATION:
Six months Ten months
Highest grade passed: E.g. Grade 10 ____________________________________ (Please attach certified copy)
School Grade applying for? ___________________________________________
School Subjects:Refer to list of subjects for 2014 (p 5)
1.__________________________ 2.__________________________3.__________________________
4.__________________________ 5.__________________________6.__________________________
7.__________________________ 8.__________________________9.__________________________
Документ1 Page 1 of7

BANKING DETAILS:
Bank :
Account name:
Account number:
Branch code:
FNB
Imbila Education (PTY) LTD
624 954 94587
252 445
Branch: Menlyn Square
CONTACT DETAILS:
Marketing & Registrations: Neels – 084 506 5233 / neels.beyers@imbila.co.za
Finance: Francois – 072 629 9725 / 012 804 9160 / francois@imbila.co.za
FEE STRUCTURE – SBA’S FOR CORRESPONDENCE STUDENTS:
SBA is an acronym for ‘School Base Assessment’. When Imbila Education refers to SBA, it refers to the
program, planning, tasks, assignments, tests and examinations that areassessed and moderated by Imbila
Education. This is the package that gives legitimacy to a learner’s work – and this is the service that Imbila
Education offers the correspondence learner/student.
In essence, your registration with Imbila Education, the registration of a learner with the Department of
Education and the utilization of the prescribed text books, offers the correspondence learner/student full legitimacy and security. (Imbila Education also assists in registration with the Department of Education.)
Grade 0-3: Two payment options on SBA’s:
Group
Grade 0 – 3
Registration fee:
Payable with registration
R1 500.00
SBA’s:
Full payment with registration
R3 000.00
SBA’s:
2 months payment option
Second payment due: 30 (thirty) days after registration
Grade 0-3: Includes all SBA’s and text books (excludes postage)
R750.00pm
Grade 4-12: Three payment options on SBA’s:
Group Registration fee:
Payable with registration
SBA’s:
Full payment with registration
SBA’s: 6 months
1 st : 30 days after reg.
SBA’s: 10 months
1 st : 30 days after reg.
Grade 4-6 (7 subjects) R2 000-00 R6 000.00
R767.00 pm R520.00 pm
Grade 7-9 (9 subjects) R2 000-00 R7 000.00
R959.00 pm R 650.00 pm
Grade 10-12 (7 subjects) R2 000.00
R6 000.00
R767.00 pm R520.00 pm
First payment is due 30 days after registration.
Grade 4-12: Text books are NOT included. Text books are purchased separately.
SACAI registration: Grade 10 R 60.00
Grade 11
Grade 12
R 250.00
R 3,950.00
Документ1 Page 2 of7

TEXT BOOKS:
Grade 0-3: SBA’s & text books are included in the package and ordered from Imbila Education.
Grade 4-12: A list of text books is available with registration. (See attachment on text books.)
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 in terms of my child’s enrolment and/or association with Imbila Education and that payment will be made on/before the 1 st of every month. I shall provide proof of payment with regard to monies paid into Imbila Education bank account to enable Imbila Education to credit my account with Imbila Education.
If I fail to make payments on pre-determined due dates, Imbila Education, will have the sole discretion to hand over the account to attorneys for collection. I undertake to pay all costs whatsoever which may be due and payable, including tracing fees, collection charges, advocate’s fees, and any expenses of whatever nature on an attorney-and-own-client scale. Any fees payable will firstly be allocated to the aforementioned costs, thereafter to interest and only then to the capital amount.
I, the undersigned, understand and agree that, once I have enrolled a learner/student at Imbila Education for a specific year and therefore received the year’s SBA’s, I am responsible for the account thereof (
You have 7 seven days to cancel the contract after receiving the product). If I have to cancel, I will fill in a cancellation form. If the Directors of Imbila accept the reason for cancellation they will only pay back the service money for the year. The service moneyis set out as follows: R250.00 per term payable in advance. I further agree to give two full calendar months’ notice at the end of the year, if I want to withdraw the learner/student from Imbila Education.
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.
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
Документ1 Page 3 of7

 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 amendments thereto.
Signed on this __________ day of ________________________________________ 20_____
____________________________________
Signature: parent/guardian/student (older than 18)
Name & surname: ____________________
Id: _________________________________
____________________________________
Signature: Person liable for payment
Name & Surname: _____________________
Id: __________________________________
Документ1 Page 4 of7

DOCUMENTATION: Please provide copies of

ID of student

ID of both parents

Proof of residence (FICA)

Report from previous school or NCA test results

Transfer certificate from previous school (where applicable)

Proof of payment
GRADE 12 STUDENTS:

Copies of Grade 10 & Grade 11 school reports

2 Colour ID photo’s are needed for the SACAI Registration Form
Where the registration form is sent electronically, please POST these 2 photo’s to:
Imbila Education,Admin, Postnet 3, Private bag x 592,Silverton, 0127
(Please write NAME & ID NO on the back of each photo, and if possible, put in small plastic bag)

1 Colour ID photo per SBA file (total of 7): KEEP these photo’s – it must be glued to each SBA file

1 Photocopy or ID per SBA file (total of 7): KEEP these also – it will be filed in each SBA file

Proof of Payment of Examination Fees – paid to SACAI (before March 2014)
Документ1 Page 5 of7

ATTACHMENT: ADDITIONAL INFORMATION (p 5 & 6)
Imbila Education – Subjects 2015
GRADE 4 to 6: GRADE 7 to 9:
English (Home Language)
Afrikaans (Eerste Addisionele Taal)
Mathematics
English (Home Language)
Afrikaans (Eerste Addisionele Taal)
Mathematics
Life Orientation
Natural Science
Social Science
Technology
Life Orientation
Natural Science
Social Science
Technology
Economic Business Science
Arts & Culture
Compulsory Subjects
English (Home Language)
Afrikaans (Eerste Addisionele Taal)
Mathematics or Mathematical Literacy
Life Orientation
GRADE 10-12
Electives (for university exemption, choose at least 2)
Physical Science (Mathematics compulsory)
Life Science
Geography
Business Studies
Engineering Graphic Design
Accounting
Economics
Agricultural Science
IT
Visual Arts
Drama
Other electives (for university exemption, 7 th subject may be 1 of the following)
Computer Applied Technology (CAT)
Tourism
Документ1 Page 6 of7

Hospitality studies
Text books for Grade 4-12:
A list of text books is available with registration or can be bought at any supplier.
Please note that:

An estimated cost for a Learner’s Book is + R200.00 and for a Teacher’s Guide, + R250.00
.

This is an ample estimation and actual prices may rather be less, than more .

The teacher’s guide is optional, but recommended (to score daily work).

Students enrolled at a Support Centre, don’t have to order the teacher’s guide.

The Supplier’s yearly price increases are usually between Feb-April each year.

Although we provide information about the text books, it remains your own responsibility to purchase them.
Imbila Education is not responsible for the supplying and distribution of text books.
Closing period over December holidays:
Marketing & Registration; Finance & Academy:
Closes 15 December 2014 – Opens 5 January 2015
Although the offices are closed during 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.
Документ1 Page 7 of7