<p> Grade: ______Admission No: ______</p><p>Admission Form 2015 – Valhalla Primary School</p><p>PO Box 21097 Cnr. Olden & Meteor Rd Valhalla Valhalla 0137 0185</p><p>Tel: (012) 654-4011 Email: [email protected] Fax: (012) 654-2306 Website: http://www.valpry.co.za </p><p>Learner’s Information</p><p>First Name: Surname: Boy / Girl: Home Language: Date of Birth: Identity Number: Place of Birth: Citizenship: Home Address: Medical History:</p><p>Postal Code:</p><p>Custody of Child (Please mark applicable option with an X): Both Parents Father Only Mother Only Relatives Guardians</p><p>NB. Previous School Details – Please complete all information Name of School: Tel / Fax: Address of School: Father’s Information</p><p>First Name: Surname: Identity Number: Email Address: Home Address: Home Tel: Work Tel: Cell No: Postal Code: Alternative No:</p><p>NB. Employer Details – Please complete all information Employer: Occupation: Address of Employer: Mother’s Information</p><p>First Name: Surname: Identity Number: Email Address: Home Address: Home Tel: Work Tel: Cell No: Postal Code: Alternative No:</p><p>NB. Employer Details – Please complete all information Employer: Occupation: Address of Employer: Brother(s) and/or Sister(s) Attending Valhalla Primary</p><p>Name Grade 1. 2. 3. 4.</p><p>Payment of School Fees</p><p>(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”</p><p>Exemptions of school fees will be granted based on certain criteria. Please contact Finance Office for further information.</p><p>Which payment option will be used to pay the school fees?(Please mark applicable option with an X):</p><p>Monthly Cash Payment School Debit Order Electronic Bank Transfer</p><p>School Bank Details (For Bank Deposits and Electronic Bank Transfer Payments): </p><p>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. </p><p>Undertaking</p><p>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. </p><p>______Parent Signature Date </p><p>Office Use Only: </p><p>Information added to school admin system Information added to school finance system </p><p>Requirement list </p><p>Please bring copies of:</p><p>Birth Certificate of learner Id of both parents </p><p>Proof of residential address</p><p>Small Id photo of learners </p><p>Clinic Card </p><p>Uniform order with Bonolo 0781310246</p><p>Aftercare Eva Gahler 082 465 6325</p>