Learner S Information

Grade: ______Admission No: ______

Admission Form 2015 – Valhalla Primary School

PO Box 21097 Cnr. Olden & Meteor Rd Valhalla Valhalla 0137 0185

Tel: (012) 654-4011 Email: [email protected] Fax: (012) 654-2306 Website: http://www.valpry.co.za

Learner’s Information

First Name: Surname: Boy / Girl: Home Language: Date of Birth: Identity Number: Place of Birth: Citizenship: Home Address: Medical History:

Postal Code:

Custody of Child (Please mark applicable option with an X): Both Parents Father Only Mother Only Relatives Guardians

NB. Previous School Details – Please complete all information Name of School: Tel / Fax: Address of School: Father’s Information

First Name: Surname: Identity Number: Email Address: Home Address: Home Tel: Work Tel: Cell No: Postal Code: Alternative No:

NB. Employer Details – Please complete all information Employer: Occupation: Address of Employer: Mother’s Information

First Name: Surname: Identity Number: Email Address: Home Address: Home Tel: Work Tel: Cell No: Postal Code: Alternative No:

NB. Employer Details – Please complete all information Employer: Occupation: Address of Employer: Brother(s) and/or Sister(s) Attending Valhalla Primary

Name Grade 1. 2. 3. 4.

Payment of School Fees

(Extract from the SA Schools Act 84 of 1996) “a Parent is liable to pay school fees determined in terms of section 39, unless, or to the extent that he/she has been exempted from payments in terms of this act. The Governing Body of a public school may, by process of law, enforce the payment of school fees by parents who are liable to pay in terms of Section 39”

Exemptions of school fees will be granted based on certain criteria. Please contact Finance Office for further information.

Which payment option will be used to pay the school fees?(Please mark applicable option with an X):

Monthly Cash Payment School Debit Order Electronic Bank Transfer

School Bank Details (For Bank Deposits and Electronic Bank Transfer Payments):

ABSA Bank Valhalla Primary School Cheque Account Account No: 1660156069 Branch Code: 632005 Reference No: Please use Learner’s Account No, e.g. MAH001. * If you don’t know the account no, use Learner name, Surname & Grade.

Undertaking

I, the undersigned will:  Allow my child to go on educational trips  Allow my child to take part in at least one summer and one winter extramural activity.  Ensure that my child wears the correct school and sport uniform.

______Parent Signature Date

Office Use Only:

Information added to school admin system Information added to school finance system

Requirement list

Please bring copies of:

Birth Certificate of learner Id of both parents

Proof of residential address

Small Id photo of learners

Clinic Card

Uniform order with Bonolo 0781310246

Aftercare Eva Gahler 082 465 6325