“GEARED TO GO FULL CIRCLE” CAMPUS KRIEL COLLEGE REGISTRATION 2017 BETHAL COLLEGE BELFAST COLLEGE “GEARED TO GO FULL CIRCLE” BELFAST AGRI COLLEGE STUDENT NUMBER (FOR OFFICE USE ONLY) Please complete the entire form in print. Mark with an X where applicable. Enrolment Date STUDENT INFORMATION ID Number DATE OF BIRTH : TITLE MR MS OTHER GENDER: MALE FEMALE RACE WHITE COLOURED INDIAN AFRICAN HOME LANGUAGE SURNAME: INITIALS: FULL NAMES: CELL: PHYSICAL ADDRESS: TEL: EMAIL: CODE: OTHER CONTACT PROVINCE WWW.CIRCLEWAYCOLLEGE.CO.ZA

STUDENT PARENTAL INFORMATION FATHER MOTHER SURNAME: FULL NAMES: ID NUMBER HOME: CELL: NEXT OF KIN (NEXT OF KIN IN CASE OF EMERGENCY) NAME AND SURNAME: CONTACT NUMBER: INFORMATION OF PERSON(S) RESPONSIBLE FOR PAYMENT OF ACCOUNT WHO IS RESPONSIBLE FOR YOUR STUDY FEES PARENT(S) STUDENT EMPLOYER GUARDIAN TRUST BURSURY CONTACT DETAILS OF PERSON RESPONSIBLE FOR YOUR STUDY FEES: INITIALS & SURNAME: CONTACT NUMBER: EMAIL POSTAL ADDRESS EMAIL EMAIL WWW.CIRCLEWAYCOLLEGE.CO.ZA

ACADEMIC HISTORY WWW.CIRCLEWAYCOLLEGE.CO.ZA NAME OF LAST SCHOOL ATTENDED: DATE OF FINAL SCHOOL YEAR HIGHEST GRADE PASSED COURSE SELECTION FULL TIME: PARTIME: COURSE TAKEN: TRIMESTER 1 TRIMESTER 2 TRIMESTER 3 SUBJECT (S) EXAM SITTING SUBJECT (S) EXAM SUBJECT (S) EXAM WWW.CIRCLEWAYCOLLEGE.CO.ZA

Declaration by applicant (This section is compulsory) CONDITIONS OF ENROLMENT 1. An applicant is accepted into any programme if he/she satisfy the minimum requirements of a programme. 2. Registration is not complete until all the fees required are paid up. 3. All fees paid as Registration Fees / Deposit are strictly not refundable. 4. The registration form should be accompanied by all relevant documentation Certified Identity document or Passport with valid visa for non South Africans Certified previous qualifications Certified proof of residence Valid proof of banking applicable to bursary students Updated Curriculum Vita 5. Read carefully and understand all the clauses of this application form before endorsing your signature. 6. All the information supplied to the college is in utmost good faith. The college reserves the right to cancel any application if the information supplied is false and if there are omissions meant to mislead College authorities. Declaration by applicant (This section is compulsory) I, the undersigned, accept and acknowledge the following clauses as part of Circleway College Policy. Paying Fees and Refunds I understand that as a student of the college I must comply with the requirements for student contribution tuition fees and any other fees as applicable, by the 4th of the month. Any fees not paid by the 4th day of the month attract 10% interest, and if the total outstanding fees for the current month is not paid by the 7th day of the month I will be excluded from classes. I also agree that all monies paid by me or my Sponsor to Circleway are non-refundable. I understand that if for any reason I drop out of the college, I will owe the College the entire duration of this contract and that the College will legally claim the outstanding fees against me or my sponsor. Exam Registration I understand that it is my responsibility to fill out a DHET examination form for the examination and that i have been told of the closing date for examination registrations. I understand that the college will not accept any late registration for examinations I understand that the College reserves the right to prohibit me from sitting for examination should there be any outstanding funds that have not been paid. I understand that I will sit a control & block test that will contribute to my final mark and that it is my responsibility to avail myself for these tests. Full Names:................................................................ Surname:.......................................................... Signed at:...................................on the....................................of..........................20............................ Signature:............................................................................................................................................... Initials and Surname:........................................................... Date:.................................................................................... SIGN HERE APPLICANT OFFICE USE ONLY Application Processed by OFFICIAL STAMP WWW.CIRCLEWAYCOLLEGE.CO.ZA

Circleway training Engineering Business Studies ICASS – MARK Stand 3 Section 1 Heinrich Street Kriel 2271 017 648 4129 or 084 040 8400 reception@circleway.co.za Postnet Suite #45 P Bag X 1036 Bethal 2310 UmalusiReg: 00874 PA, 00912PA, 00913PA, 00915PA Teta-12/231 Addendum to Registration Contract ICASS – MARK Engineering You are hereby informed that: Your ICASS-Mark consist of: 30% of your Test 1 (Controlled Test) marks and 70% of your Test 2 (Block Test) marks Business Studies 20% of an assignment mark. 30% of Test 1 (Controlled Test) marks. 50% of Test 2 (Block Test) marks. Take note that if you are a full-time or part-time (not attending) student the above ruling will apply. Student Q+A Manager 16570 WWW.CIRCLEWAYCOLLEGE.CO.ZA