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CHECKLIST / KONTROLELYS Please Make CHECKLIST / KONTROLELYS Please make sure the following is included in your completed application form. Maak asseblief seker die volgende is ingesluit in jou voltooide aansoekvorm. 1. Copy of pupil’s latest school report Afskrif van leerling se jongste rapport 2. Copy of ID document/unabridge birth certificate Afskrif van leerling se identiteitsdokument/volledige geboortesertifikaat 3. Copy of both parent’s ID document Afskrif van beide ouers se identiteitsdokumente. 4. 2 passport photographs 2 paspoortfoto's 5. Completed Substance Abuse form Voltooide Ontoelaatbare Middele vorm 6. Proof of residential address (only a municipal account/lease agreement). Bewys van woonadres (slegs ‘n munisipale rekening/huurooreenkoms) 7. Application signed by both parents and learner. Aansoek deur beide ouers en leerder geteken. 8. Subject choice form for grade 10 – 12 applications Vakkeuse vorm vir graad 10 – 12 aansoeke Download and print application forms. Laai aansoekvorms af en druk. Application forms must be handed in at PAREL VALLEI HIGH SCHOOL reception. Please note that only one person at a time will be allowed at reception. All Covid-19 regulations must be adhered to. Aansoekvorms moet by HOËRSKOOL PAREL VALLEI se ontvangs ingehandig word. Wees asseblief bewus daarvan dat slegs een persoon op ‘n slag in die gebou toegelaat sal word. Alle Covid-19 regulasies sal in plek wees. Please make sure that ALL the above documentation is included in the application before handing it in. Maak asseblief seker dat AL die bogenoemde dokumente ingesluit is in die aansoek voordat dit ingehandig word. Please note that an incomplete application will not be considered. Let wel dat ‘n onvolledige aansoekvorm nie oorweeg sal word nie. OFFICE USE ONLY AANSOEK OM TOELATING TOT / APPLICATION FOR ADMISSION TO Family code Publieke skool soos omskryf Public school as defined by in die Onderwyswet van 1996 the Education Act of 1996 …………………………………………….. Admin. nr Parel Valleiweg 95 95 Parel Vallei Road SOMERSET-WES SOMERSET WEST …………………………………………….. Tel: 021 852 1228 Tel: 021 852 1228 Faks: 021 852 5005 Fax: 021 852 5005 Date of admission [email protected] [email protected] _____ / _____ / 20 ___ www.pvallei.co.za www.pvallei.co.za Office use only / Slegs vir kantoorgebruik Applicant: Surname First name Aansoeker: Van ___________________________________ Eerste naam _______________________________ Grade at admission: Section: Principal: Graad by toelating: ________________ Seksie: ______________ Hoof: __________________________________ This form must be completed in full. Copies of the following documents must accompany this Birth certificate application: 1) unabridged birth certificate of learner and I.D. document of both parents, 2) two passport photographs, Passport photos 3) latest report, 4) signed Substance Abuse form and 5) proof of residential address (only a municipal account or lease agreement) Report Hierdie vorm moet volledig ingevul word. Kopieë van die volgende dokumente moet hierdie aansoek vergesel: 1) volledige geboortesertifikaat van leerder en ID-dokument van beide ouers, 2) twee paspoortfoto’s, Substance Abuse 3) jongste rapport, 4) getekende ooreenkoms oor Ontoelaatbare Middels en Residence 5) bewys van woonadres (slegs ‘n munisipale rekening of huurooreekoms) IN OUT Any information provided in this application which is found to be false or incorrect, will lead to the rescinding of the admission of this applicant. Sou enige inligting, soos deur die aansoeker verskaf, vals of foutief wees, sal toelating tot die skool onmiddellik teruggetrek word. A LEARNER’S PARTICULARS / LEERDER SE BESONDERHEDE Surname: Grade for admittance: Van: _____________________________________________ Graad vir toelating: _____________ Full names: Voorname: _______________________________________________________________________________ Name known by: Date of birth: D / D / M / M / YY / JJ Noemnaam: ______________________________ Geboortedatum: ______ / ______ / ___________ Sex: ID no: / ID nr: Geslag: _____________ Cell no: / Sel nr: Learner’s physical address / Leerder se fisiese adres Learner’s e-mail address / Leerder se e-posadres Present school: Huidige skool: _________________________________________________________________________________________________ Previous school attended in Western Cape: Year: Vorige skool in Wes-Kaap bygewoon: __________________________________________________________ Jaar: ___________ Geloof / Religion: ____________________________ Huistaal / Home language: ____________________ Number of children in family: Is learner the 1st, 2nd, 3rd, etc. child in the family?: Getal kinders in gesin: ________ Is leerder die 1ste, 2de, 3de, ens. kind in die gesin?: __________ Brother(s) / sister(s) / Name / Naam Surname / Van Grade Year past pupils at Parel Vallei: Broer(s) / suster(s) / oud-leerders in Parel Vallei: B PARTICULARS OF PARENTS / BESONDERHEDE VAN OUERS Father or Guardian Mother or Guardian Vader of Voog Moeder of Voog Title, name and surname Titel, naam en van ID number ID-nommer Postal address Posadres Home address (if different from postal address) Woonadres (indien verskillend van posadres) E-mail address (work) E-pos-adres (werk) Official communication email address Primêre e-pos adres vir kommunikasie Occupation Beroep Employer Werkgewer Telephone numbers Home Home Telefoonnommers Tuis (______) ___________________________ Tuis (______) ___________________________ Work Work Werk (______) ___________________________ Werk (______) ___________________________ Cell Cell Sel (______) ___________________________ Sel (______) ___________________________ Marital status Married Divorced Separated Single Huwelikstatus Getroud Geskei Woon apart Enkel Combined annual income Less than R300 000 p. a. R300 000—R450 000 p.a. / p.j. Minder as R300 000 p.j. Gesamentlike jaarlikse inkomste R450 000 - R600 000 p.a. / p.j. R600 000 + Learner and Parent to sign / Leerder en Ouer moet teken: I acknowledge receipt of the school’s code of conduct, substance abuse agreement and cellphone policy, understand the contents and agree to abide by them. Ek erken ontvangs van die skool se gedragskode, ooreenkoms by misbruik van ontoelaatbare middele en die selfoonbeleid, verstaan die inhoud daarvan en onderneem om daarby te hou. Signed: Geteken: ……………..…..…..…… ………………..…..…………….. …………...…..…….……… Learner / Leerder Father/Guardian / Vader/Voog Mother/Guardian / Moeder/Voog ………………………………….. Date / Datum C SUBJECT CHOICE / VAKKEUSE GRADE(S) 8 & 9 The following learning areas are compulsory Die volgende leerareas is verpligtend: ENGLISH Home Lang First Add Languages / Tale (Please mark the appropriate blocks) AFRIKAANS Huistaal Eerste Add (Merk die toepaslike blokke, asb.) Mathematics / Wiskunde Life Orientation / Lewensoriëntering Human and Social Sciences / Mens– en Sosiale Wetenskappe Natural Sciences / Natuurwetenskappe Economic and Management Science / Ekonomiese en Bestuurswetenskappe Technology / Tegnologie Creative Arts / Kreatiewe Kunste ALL LEARNERS WILL TAKE DRAMA and will then select ONE of the options below ALLE LEERDERS SAL DRAMA NEEM en dan EEN van die volgende kies. Learners will be streamed according to their skill level. Leerders sal volgens hulle vaardigheid gegroepeer word. To be able to take Piano, at least Gr 2 in an external Design/Ontwerp Music/Musiek examination is required. All other instruments may be started without any experience. Gr. 2 in ’n eksterne eksamen is die minimum toelatingsvereiste vir klavier. Alle ander + Drama + Drama instrumente mag sonder enige ervaring geneem word. Sport and Cultural activities / Sport- en kultuuraktiwiteite SUMMER / SOMER WINTER CULTURE / KULTUUR GRADE(S) 10, 11 & 12 Please complete annexure A [Subject Choice Form]. / Voltooi asb. aanhangsel A [Vakkeusevorm]. NB Please ensure that your name is filled in on this form and that it is signed by the learner and parent. Maak seker dat u naam op die vorm ingevul is, en dat dit deur beide die ouer en die leerder onderteken is. D MEDICAL INFORMATION / MEDIESE GEGEWENS Name of medical aid society: Name of member: Naam van mediese hulpfonds: ________________________ Naam van lid: ________________________ Number: Any allergies: Nommer: _____________________________ Enige allergieë: ____________________________________ MEDICAL & PERSONAL HISTORY/ MEDIESE & PERSOONLIKE GESKIEDENIS Please attach any relevant documentation regarding any ailment, disease or disability which the school should know about. / Heg asseblief hierby aan enige dokumentasie oor siekte of gestremdheid waarvan die skool moet weet. E IMMIGRANT / REFUGEE / VLUGTELING Date of immigration: ______________________________ Country of origin: ___________________________ Date of refugee status: Departmental exemption number: ______________________________ Attach certified proof of immigrant, refugee status and study permit. F CONSENT, INDEMNITY AND ACKNOWLEDGEMENT OF DEBT WITH RESPECT TO SCHOOL FEES TOESTEMMING, VRYWARING EN ERKENNING VAN SKULD TEN OPSIGTE VAN SKOOLGELD Consent and indemnity I hereby give my consent for my child to take part in extramural activities for the school, including educational excursions / tours, cultural and sports activities while attending this school. I fully understand and accept that my child’s participation in all tours, excursions and sports activities shall be undertaken at indemnity, hold harmless and absolve the Governing Body, Principal and Staff against any or all claims whatsoever that may arise in connection with my aforesaid child
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