1. JBAY ACADEMY Grade 8-12 Application Form 2016 LEARNER NAME:__________________________ GRADE: _________________________________

2. APPLICATION FOR 2016 NAME OF LEARNER: GRADE APPLYING FOR: CURRENT SCHOOL: LEARNERS MEDICAL INFORMATION MEDICAL AID: MEDICAL AID NO: MAIN MEMBER: NAME OF GP: GP TEL: ALLERGIES: IMMUNISATION: SPECIAL MEDICAL PROBLEMS REQUIRING COUNSELLING:

3. LEARNER DETAIL FULL NAME AND SURNAME: DATE OF BIRTH: HOME LANGUAGE: HOME ADDRESS: PLACE OF CHILD IN THE FAMILY (1 ST, 2 ND, 3 RD CHILD): OTHER DETAIL PHYSICAL DISABILITIES: LEARNING DISABILITIES: SOCIAL DISABILITIES: PLEASE INDICATE ANY APPROPRIATE INFORMATION IN THE FOLLOWING AREAS

4. OTHER DETAIL MOTHER NAME: WORK ADDRESS: WORK TEL: CELL: EMAIL: FATHER NAME: WORK ADDRESS: WORK TEL: CELL: EMAIL: EMERGENCY CONTACT (OTHER THAN PARENTS): WHO WILL COLLECT THE CHILD AT THE SCHOOL: TEL:

5. SCHOOL FEES 1.Who will be responsible for the school fees: 2.Payment method 3.School fees are payable in advance by the 1 st and not later than the 7 th of each month. 4.The parents must be aware that the school fees are payable in 11 Months. 5.Parents are jointly liable for the payments of the school fees. 6.In event of the parents being in default of payment of the school fees-interest at the rate of 20% per annum will be levied on all such amounts which are due as calculated from the date upon which it became payable. 7.Legal steps will be instituted against them without prior notification for the recovery of such arrear fees in which event the parents will be liable for all legal costs and expenses as between attorney and own client including such collection commission which may lawfully become due. Cancellation – 2 months notice. 8.Banking details: Jbay Academy Standard Bank Branch code: 050315 Account: 252461398 Reference: Student name and grade 9. The school fees include the curriculum plus school fees for the year. Payments are calculated over 11 months. FEES FOR 2016 -Non refundable registration fee of R550-00 payable on submission of Application. -Monthly School fees - R2 070 per month for 1 child - R1 870 per month for every child more than one. Half year payment in advance / 2% discount – R 12 170 Full year payment in advance / 5% discount – R 21 630 -Aftercare: -R500 per month for 1 child -R350 per month for every child more than one. CASHDEBITEFT

6. PLEASE ATTACH THE FOLLOWING WITH EVERY APPLICATION (School to complete the tick box below) 1.Copy of most recent school report 2.Copy of any professional reports 3.Copy of unabridged birth certificate 4.Edu@Home registration form 5.Proof of payment for: - Registration fee - Edu@Home registration RESPONSIBILTIES OF PARENT & LEARNERS -LEARNER MUST BEHAVE IN ORDERLY MANNER -MUST ACCEPT DISCIPLINE WHICH IS NECESSARY FOR THE GOOD FUNCTIONING OF THE ACADEMY -MUST ATTEND ACADEMY FAITHFULLY NAME OF PARENT _____________________________________SIGNATURE PARENT DATE: ______________ JBAY ACADEMY___________________________

7. Name of Student: Grade: Subject Choices Grade 4-6Grade 7-9 English ( Home Language) Afrikaans ( Eerste Addisionele Taal)Arikaans ( Eerste Addisionele Taal) MatheematicsMathematics Life Orientation Natural Science Social Science Technology Economic Business Science Arts and Culture Grade 10-12 Compulsory SubjectsElectives ( for university exemption, choose at least 2)Mark with X English ( Home Language)Physical Science ( Mathematics compulsory) Afrikaans (Eerste Addisionele Taal)Life Science Mathematics or Mathematical LiteracyGeography Life OrientationBusiness Studies Engineering Graphic Design Other electives (for university exemption, 7th subject may be 1 of the following)Mark with X Computer Applied Technology (CAT) Tourism Hospitality Studies Visual art Drama