PMB 20

MIDLANDSAddress:

Tel:

Admin Block, Room D 203lndumiso Campus Riverside Campus(033) 845 8951 (033) 845 8815

REGISTRATION OF SUBJECT/S FOR NON-CERTIFICATE /DIPLOMA/DEGREE PURPOSES

STUDENT DETAILS

Student Number

Surname First Name/s

Identity Number

Passport Number (International Student)

Postal Address

Postal Code

Contact Number/s Home Work Cell

Email Address

Routing: Student → Head of Department → Faculty Office

NOTE: I. The onus is on the student to ensure that all fees are paid timeously.II. An incomplete form will not be processed.III. Completed form to be returned to the Faculty Office.IV. A student Biographical and Indemnity form which is obtainable from the Faculty Office must be completed and attached to this form.V. Surety form obtainable from the Finance Department must be completed and submitted to the Finance Department.

PMB 20 Details of Current Registration (Only applicable if you are currently registered)

Qualification Description Qualification Code Qualification Block Code Qualification Offering Type

Details of Registration for Non-Certificate/Diploma/Degree Purposes

Qualification Description Qualification Code

Subject Description Subject Code

Subject Block Code

Subject Offering Type

Signature of Student ........................................................................... Date .....................................

The aforementioned amendments comply with all the relevant institution rules and are hereby authorised by Programme

1. Head of Department (where applicable)

Name ............................................................................................................... Signature ..................................................................................... Date .....................................

2. Non-diploma/certificateHead of Department/s in which Non-diploma/certificate subjects is/are taught

(i) Name of HoD ............................................................. Academic Department ...................................................... Signature .................................................. Date ..........................

(ii) Name of HoD ............................................................. Academic Department ...................................................... Signature .................................................. Date ..........................

FOR OFFICE USE

Received by Date

Processed by Date

Checked by Date

Faculty Officer Date

Routing: Student → Head of Department → Faculty Office