APPLICANT DETAILS

First Name/s

Surname

I.D Number Date of Birth yyyy - mm - dd

Race ColouredAfricanOther Indian White

Gender FemaleMale

Please complete this form as per applicant’s ID document.

CONTACT DETAILS ADDRESS

Mobile:

Mobile:

Home:Email:

House/Flat:

Street:

Suburb:Province:

Home Language

Previous School

Does the learner require special concessions for the examination? YES NO

FOR OFFICE USE ONLY:

Amount Paid:

Name of Capturer:

Signature:REGISTRATION NUMBER

If yes, please specify and attach supporting documents from your previous school.

N.B Learners will not be allowed to register for subjects which do not appear on their statement of results.

ENGLISH HL

ENGLISH FAL

AFRIKAANS FAL

MATHEMATICS

MATH. LITERACY

PHYSICAL SCIENCES

LIFE SCIENCES

BUSINESS STUDIES

ACCOUNTING

ECONOMICS

GEOGRAPHY

TOTAL NUMBER OF SUBJECTS REGISTERED FOR:

CANCELLATION CompleteCancellation YES NO Subject:

ADD ONS

Date:

APPLICATION FORM2020 Matric Rewrite Online

Please tick next to the subjects which you are registering for: (Venue, Day & Session to completed by Star Schools)

BRAAMFONTEINONLY

BRAAM VAAL

KZN PMB

If yes, when is the due date: NO Are you pregnant? YES Please indicate the nature of your illness

Do you take any medication?

Who is your emergency contact person/doctor?

SUBJECT CHOICES

Emergency contact number?

PARENT DETAILS

How did you hear about Star Schools, please specify for each platform .i.e RADIO - YFM?

RADIO

FLYERS

Full Names:Mobile:Work:Home:Email:

SCHOOL

FRIENDSPRINT MEDIA SOCIAL MEDIA

Other (Specify)

CODE OF CONDUCT

The Star Schools Code of Conduct has been developed considering a climate of trust, mutual respect and understanding of each other’s feelings, culture, race, gender, age, disability, religion and language.

The following rules apply to all learners attending the Star Schools programmes:

BehaviourLearners are expected at all times to behave in a courteous and considerate manner towards each other.

Punctuality and AttendanceAll learners are to arrive at school before the official starting time of each session.Learners who are later than 5 minutes will NOT be allowed into the classroom.

Dress CodeLearners should dress neatly and presentably.

Personal BelongingsStar Schools will not be held responsible for theft of or damage to personal belongings on school premises (e.g. cell phones, bags, books and clothing items).

DISMISSABLE OFFENCESWillful damage, vandalisation or neglect of school property and the property of others, either by writingor by physical act, is prohibited. Theft of school and private property is also prohibited. Language that is seen as derogatory, discriminatory or racist is prohibited.All learners have the right to an education free of interference, intimidation and/or physical abuse.Learners will respect the property and safety of other learners.Fighting or threatening of other learners is forbidden.The carrying, copying and/or reading of o�ensive material is prohibited.

SafetyThe school is a place of safety where laws pertaining to public spaces are applicable. No dangerous objects or illegal drugs as de�ned in the SA Schools Act or the Safety Regulations will bebrought into and/or used on the school property. Dangerous objects includes knives, �rearms or any itemthat could harm a person.The carrying and/or smoking of cigarettes and marijuana in the area of the school is prohibited.Alcohol and drunkenness are not permitted on school premises.The carrying of and/or consumption of illegal chemical substances and drugs is prohibited.

NB: Parent(s)/guardians will be informed of any o�ence. Depending on the nature of the o�ence a disciplinaryhearing will be held to decide on the learner’s admission to Star Schools.

PRINT MEDIA

1. Understanding that Star Schools will NOT BE RESPONSIBLE for CONDUCTING and SUBMITTING anySBAs (School Based Assessments).

2. Understanding that Star Schools will not be responsible for correcting and rectifying issues if I haveREGISTERED AT TWO DIFFERENT INSTITUTIONS. I will refrain from registering at Star Schools andanother institution.

3. Understanding that Star Schools conducts examinations at Star Schools and a venue off campuswhich will be communicated to me in August of that year.It is my and parents’/guardians’ responsibility to ensure that I arrive at these venues on time. If I missan exam I will NOT be allowed to rewrite in May of the following year as part-time learners do NOTqualify to write supplementary exams.

4. Attending all my sessions for the subjects that I have registered for. I further understand that if myattendance is less than 85%, Star Schools has the right to deregister me and prevent me fromwriting the examinations without any refund of fees.

5. Writing all assessments as set out by Star Schools. If I am unable to write, then I will submit a medicalcertificate or a letter of motivation. This, however, does not guarantee that I will be able to write a“make-up assessment”.

6. Understanding that Star Schools will not process any refunds or cancellation after threeweeks of registration and after 31 March.

LEARNER COMMITMENT

I, ____________________________________, a learner at Star Schools, understand the Code of Conductand the implications and hereby also commit to:

Learner Signature: __________________________

Date: __________________________

Parent Signature: __________________________

Date: __________________________

FOR OFFICIAL USE ONLY

ADD – ON’S OVERPAYMENTS

CANCELLATIONS SPECIAL CONSIDERATIONS

DATE NATURE OF QUERY NAME SIGNATURE

OTHER INFORMATION