In an effort to improve the user experience and make it easier for patients to register for appointments, CEMIS has released a new registration form. The form is shorter and includes fewer fields, making it simpler to complete. Patients are encouraged to take advantage of this simplified process and register for their next appointment online. Additionally, visitors can use the new form to request information about our services or schedule a consultation. We appreciate your interest in our practice and look forward to serving you!
| Question | Answer |
|---|---|
| Form Name | Cemis New Registration Form |
| Form Length | 2 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 30 sec |
| Other names | cemis, https cemis westerncape gov za, cemis westerncape gov co za, wced cemis school login |
EMIS
WESTERN CAPE EDUCATION DEPARTMENT
CEMIS: NEW REGISTRATION FORM
Please note that this form must be completed for all NEW learner registrations (learners that are NOT CURRENTLY registered in the CEMIS). The form must be signed by the parent/guardian and the principal. It is important to collect learner information in terms of gender, race and disability in order to track the extent to which EQUITY and ACCESS are being addressed.
Please observe the following strictly:
1.The form must be completed by an official, parent or guardian, not the learner.
2.Race, gender, social grant and disability detail should be collected with sensitivity from the parent/guardian.
1.Surname
2.First name
3.Second and third name
4. Learner’s Identity Number
If the identity number is not available, apply to Home Affairs immediately.
**Is the learner an immigrant: 1=yes; 2=no
5.Date of birth
Year
Month |
Day |
6.Learner’s race: 1=black/african; 2=coloured; 3=Indian/Asian; 4=white; 5=not applicable
Diacritics on name: 1=yes 2=no
7.Learner’s gender: 1=male; 2=female
8a.Street number or write |
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8b.Name of street/ |
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Plot / Farm / Flat |
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plot / farm / flat |
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8c.Suburb / Address line 2 |
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8d.Town / Address line 3 |
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** Telephone code and number or |
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8e.Postal code |
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cellular phone number |
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9. Learner’s parents deceased: 1=only mother deceased; 2=only father deceased; 3=both parents deceased; 4=both parents alive; 5=unknown
10.Is it the first time the learner has registered at a school in the Western Cape Province? 1=yes; 2=no; 3= comes from independent/private school
11.In which province or country did the learner attend school LAST year?: 1=Western Cape; 2=Free State; 3=Gauteng;
12.Learner’s grade this year:
15=Special Grade 7; 16=Special Grade 8; 17=Special Grade 9; 18=Infant Phase; 19=Junior Phase; 20=Intermediate Phase; 21=Senior Phase; 22=Vocational phase;
23=ABET Level 1; 24=ABET Level 2; 25=ABET Level 3; 26=ABET Level 4; 27=N1; 28=N2; 29=N3; 30=N4; 31=N5; 32=N6; 33=NIC; 34=NSC; 35=LSEN Unit
13.If the learner is in a
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14.In which class is the learner this year? E.g. 3c or 12a |
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15.Did the learner attend any school last year? 1=yes; 2=no |
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16.Is the learner a hostel boarder this year? 1=yes; 2=no |
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17.Is the learner registered for a social grant? 1=yes; 2=no |
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18.Does the learner receive a social grant? 1=yes; 2=no |
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19.Did the learner attend any formal or |
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20.Does the learner benefit from the Primary School Nutrition |
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LAST year? (Only applies to Gr1 first time enrolments) 1=yes; 2=no |
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Programme (PSNP)? 1=yes; 2=no |
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21.Is the learner 1=mainstream; 2=LSEN in unit class; 3=LSEN in mainstream; 4=in a LSEN school?
22.Learner according to disability (leave blank if no disability) 2=deaf; 3=hard of hearing; 4=blind; 5=partially sighted; 7=cerebral palsied; 8=specific learning disabled; 9=behavioural disorder; 10=mild/moderate intellectually disabled; 11=severely intellectually disabled; 12=physically disabled; 13=autistic spectrum disorder; 14=epilepsy; 15=attention deficit disorder with
hyperactivity; 16=none; 17=attention deficit disorder without hyperactivity |
Sec. Dis. 1 |
Sec. Dis. 2 |
Sec. Dis. 3 |
Sec. Dis. 4 |
Primary disability
Secondary disabilities (This field is only to be completed if the learner has more than one disability)
23.Learner’s home language: 1=Afrikaans; 2=English; 3=Xhosa; 4=Swati; 5=Ndebele; 6=Zulu; 7=Sotho; 8=Pedi; 9=Tswana; 10=Venda; 11=Tsonga;
12=Sign Language; 13=Other: specify below
24.Learner’s language of teaching: 1=Afrikaans; 2=English; 3=Xhosa; 4=Swati; 5=Ndebele; 6=Zulu; 7=Sotho; 8=Pedi; 9=Tswana; 10=Venda; 11=Tsonga;
12=Sign Language; 13=Other: specify below
25.Learner’s preferred language/Certificate language: 1=Afrikaans; 2=English; 3=Xhosa; 4=Swati; 5=Ndebele; 6=Zulu; 7=Sotho; 8=Pedi; 9=Tswana; 10=Venda;
11=Tsonga;12=Sign Language; 13=Other: specify below
EMIS
26.Languages in GET band (Grades 1 – 9)
Indicate the PRIMARY, ADDITIONAL and 2nd ADDITIONAL LANGUAGES of the learner. (This question refers to the languages taught in the LANGUAGE, LITERACY and
COMMUNICATION Learning Area.)
1=Afrikaans; 2=English; 3=Xhosa; 4=Swati; 5=Ndebele; 6=Zulu; 7=Sotho; 8=Pedi; 9=Tswana; 10=Venda; 11=Tsonga; 12=Sign Language; 13=Other: specify below
Complete only for learners who take a second primary language.
Primary language
Additional language
2nd Additional language
2nd Primary language
Other Language
27.Examinable secondary subjects taken in the FET band (Grades 10
Subject Name
?(Grades 10 and 11 use NCS FET subject names for 2007 with no subject grade distinction). Minimum of seven subject required for fulltime learners.
?(Grades 12 for 2007 will be the last to use the old subject names with subject grade distinction). Minimum of six subjects required for fulltime learners.
Subject Category:
1=at the school as part of the subjects;
2=at another institution as part of the subjects;
3=extra subjects at the school;
4=extra subjects at another institution
Subject Grade 1=HG
2=SG
3=n/a
28. The six main
1.Dance
2.Drama
3.Music
4.Choir
Other: Specify with code (1,2 or 3)
5.Visual art |
6.Athletics |
7.Chess |
8.Cricket |
9.Hockey |
10.Netball |
11.Clay pigeon |
shooting |
12.Softball |
13.Soccer |
14.Rugby |
15.Tennis |
16.Volleyball |
17.Watersport
18.Debating society
19.Boxing
20.Karate
I, the principal, hereby declare that I have established that the
We, the undersigned, fully understand the provision made in the South African Schools Act, Act 84 of 1996 (Section 59(2)) regarding the duty of schools to provide information.
Signed: |
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Parent / Guardian |
: ...........................................………………. |
......................................……………. |
…....................…….. |
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(Name in Print) |
Signature |
Date |
Principal |
: ...........................................………………. |
......................................……………. |
…....................…….. |
|
(Name in Print) |
Signature |
Date |