Applications – Grace Christian Private School

Application form

Note: this form must be completed in full: All changes to be initialed or signed by parent/guardian. Completing the form does not necessarily mean that the learner has been accepted into the School
Grade Applied For*
Please enter a number from 0 to 12.
Highest Grade Passed*
Year When Grade Was Passed*
Accession No*
Learner’s Personal Information
Surname*
First Name*
Initials*
Nick Name:
Other Names
Date of Birth*
YYYY dash MM dash DD
Gender*
Race*
ID or Passport No*
Please enter a number from 13 to 13.
Country of Residence*
Citizenship*
If SA, indicate province of residence
Learner’s Contact Information
Physical Address*
Home Telephone*
Emergency Telephone*
Learner Cell
City/Suburb*
Code*
Learner Email Address*
Home Language*
Preferred Language of Instruction*
Boarder:
Deceased Parent
Mode of transport
Religion*
For Grade 1 only: Indicate pre-primary education
Previous School Information
Name of Previous School*
Previous School Address*
Code*
Province*
Country*
Learner’s Medical Information
Medical Aid Number
Medical Aid Name
Medical Aid Main Member
Doctor Name
Doctor’s Address
Doctor’s Telephone
Medical Condition
Reg. Social Grant
Special Problems Requiring Counseling
Dexterity of Learner
Learner’s Siblings at the School
Number of other Children at this school
Position in the family (e.g. first)
Names
Grade
Please enter a number from 0 to 12.
Names
Grade
Please enter a number from 0 to 12.
Names
Grade
Please enter a number from 0 to 12.
Parent/Guardian Information
Title
Initials
Surname*
First Name*
Home Language
Gender
ID or Passport No
Please enter a number from 13 to 13.
Account Payer
Postal Address
City/Suburb
Code
Occupation
Employer
Surname of Spouse
First Name
Occupation of Spouse
Learner resides with this parent/s
Spouse ID No
Relationship to Learner
Marital status of parent
Correspondence Details
Title
Surname*
Postal Address
City/Suburb
Code
Home Telephone
Work Telephone
Fax Number
Cell Number
Spouse Work Telephone
Spouse Cell Number

Application Form

Application form

Learner’s Personal Information

Learner’s Contact Information

Previous School Information

Learner’s Medical Information

Learner’s Siblings at the School

Parent/Guardian Information

Correspondence Details