Embarking on the journey of education with Northern Academy requires a thorough and detailed initial step: completing the Application for Admission form. This comprehensive document, crafted by the academy and its management entities, Meridian Operations Company NPC and Campus and Property Management Company (Pty) Ltd, serves as a bridge between prospective students and a quality education. It prompts applicants to specify their desired school year and grade, including options for nursery through to grade 12, and to confirm the availability of additional services such as hostel accommodation and aftercare—highlighting the academy’s dedication to providing a holistic educational environment. A meticulous completion of this application is mandatory, necessitating signatures and the attachment of all pertinent supporting documents like identification, academic records, and proof of financial capability. Furthermore, the form delves into learners' personal details, academic history, medical information, and family background, ensuring a comprehensive understanding of the student's needs and circumstances. Notably, the application emphasizes adherence to the school’s Christian principles and policies on conduct, substance abuse, and dress code. This preparatory step underscores the academy’s commitment to fostering an informed, respectful, and inclusive community from the outset.
| Question | Answer |
|---|---|
| Form Name | Northern Academy Application Form |
| Form Length | 7 pages |
| Fillable? | No |
| Fillable fields | 0 |
| Avg. time to fill out | 1 min 45 sec |
| Other names | northern academy school fees 2021 polokwane, northern academy polokwane application forms for 2021, northern academy independent school polokwane fees 2021, northern academy school fees 2022 |
NORTHERN ACADEMY APPLICATION FOR ADMISSION
Meridian Operations Company NPC (RF) Reg No 2012/081855/08 / NPO Reg No
Campus and Property Management Company (Pty) Ltd Reg No 2012/001821/07 / VAT Reg Number 4290261926
SCHOOL APPLIED AT |
NORTHERN ACADEMY |
MONTH & YEAR APPLIED FOR
GROUP OR GRADE APPLIED FOR |
GROUP 1 |
Confirm availability at applicable school
1.5
2
2.5
3
4
5
(NURSERY SCHOOL)
GRADE R 1 2 3 4 5 6 7 8 9 10 11 12
(SCHOOL)
HOSTEL ACCOMMODATION |
YES |
Confirm availability at applicable school
AFTERCARE |
YES |
Confirm availability at applicable school
MOST IMPORTANT
NO
NO
This Application for Admission will only be processed if ALL fields are completed legibly, are signed and ALL relevant supporting documents are attached.
Ref 2013/001
REQUIRED SUPPORTING DOCUMENTS, COMPLETED SECTIONS & FORMS
CEMIS Transfer Document once available
Copy of Learner's FINAL Progress Report once available Copy of Learner's latest Progress Report
Copy of Learner's Birth Certificate / ID Document Copy of Learner's Vaccination Records if available
Copy of Learner's Residence / Study Permit, if Foreign
Copy of Parents' / Legal Guardians' ID Documents
Proof of Household Income (See Section 8) Proof of Registration Fee Payment Completed Hostel Application if applicable Completed Aftercare Application if applicable Completed Debit Order Form if applicable Subject Choice Form (FET Phase: Gr 10 - Gr 11) Sections 1 - 14 Completed & Signed
TWO RECENT
COLOUR PHOTOS
OF LEARNER
(ID SIZE)
FOR OFFICE USE
INTERVIEW DATE
NOTES
APPROVED
DATE
COMMENCEMENT DATE
GROUP / GRADE
FAMILY CODE
LEARNER NR
SIBLINGS AT |
1 |
THE SCHOOL
2
SECTION 1 : LEARNER'S PERSONAL DETAILS
SURNAME |
FULL NAMES AS ON BIRTH CERTIFICATE / ID DOCUMENT |
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PREFERRED NAME |
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IDENTITY NUMBER |
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DATE OF BIRTH Y Y Y Y |
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D D |
AGE |
GENDER |
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MALE
FEMALE
HOME & OTHER SPOKEN LANGUAGE/S |
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OTHER |
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LANGUAGE/S OF LEARNING & TEACHING |
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SECOND |
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NUMBER OF CHILDREN IN FAMILY |
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POSITION OF LEARNER IN FAMILY |
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NATIONALITY |
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COUNTRY OF ORIGIN |
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DATE OF IMMIGRATION |
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RACE
RELIGION
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AFRICAN |
COLOURED |
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INDIAN |
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WHITE |
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OTHER |
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RESIDENCE |
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PARENTS |
GUARDIANS |
HOSTEL |
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MEANS OF TRANSPORT TO/FROM SCHOOL
LEARNER'S CELL PHONE NUMBER
MOTOR VEHICLE |
MOTORBIKE |
BUS |
TAXI |
BICYCLE |
WALK |
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PAGE 1 OF 7
SECTION 2 : LEARNER'S EDUCATIONAL DETAILS
CURRENT SCHOOL |
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PREVIOUS SCHOOL |
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PRINCIPAL |
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PRINCIPAL |
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LAST GRADE PASSED |
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YEAR |
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GRADE/S REPEATED |
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HAS ADMISSION TO ANY OTHER SCHOOL/S EVER BEEN REFUSED? IF YES, PLEASE STATE REASON. |
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YES |
NO |
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REASON |
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ACADEMIC ACHIEVEMENTS |
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EXTRACURRICULAR ACHIEVEMENTS |
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OTHER ACHIEVEMENTS |
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SECTION 3 : LEARNER'S MEDICAL DETAILS
BLOOD TYPE |
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O- |
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A+ |
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AB+ |
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UNKNOWN |
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FAMILY DOCTOR |
NAME |
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TEL NO |
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ADDRESS |
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MEDICAL AID |
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NUMBER |
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MAIN MEMBER INITIALS & SURNAME |
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ID NR |
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OPTIONS |
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HAS THE LEARNER RECEIVED ALL THE NECESSARY IMMUNISATIONS? IF NO, PLEASE STATE REASON. |
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YES |
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NO |
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REASON |
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HAS THE LEARNER SUFFERED FROM ANY OF THE FOLLOWING ILLNESSES? PLEASE INDICATE WITH AN X. |
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ASTHMA |
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ENTERIC FEVER |
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MEASLES |
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SCARLET FEVER |
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CHICKEN POX |
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GERMAN MEASLES |
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MUMPS |
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TICKBITE FEVER |
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DIABETES |
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HEPATITIS |
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POLIO |
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TYPHOID FEVER |
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DIPHTHERIA |
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MALARIA |
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RHEUMATIC FEVER |
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WHOOPING COUGH |
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DOES THE LEARNER SUFFER FROM ANY ALLERGIES? |
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YES |
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NO |
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IF YES, PLEASE GIVE DETAILS. |
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DOES THE LEARNER HAVE ANY SPECIAL MEDICAL NEEDS?
IF YES, PLEASE GIVE DETAILS.
YES
NO
DOES OR HAS THE LEARNER SUFFERED FROM ANY OTHER ILLNESSES OR DISABILITIES?
IF YES, PLEASE GIVE DETAILS.
YES
NO
PAGE 2 OF 7
SECTION 3 : LEARNER'S MEDICAL DETAILS - CONTINUED
IS THE LEARNER RECEIVING MEDICAL TREATMENT FOR ANY CONDITION?
IF YES, PLEASE GIVE DETAILS.
YES
NO
IS OR HAS THE LEARNER SUFFERED FROM OR RECEIVED TREATMENT FOR ANY PSYCHOLOGICAL OR EMOTIONAL UPSET?
IF YES, PLEASE GIVE DETAILS.
YES
NO
HAS THE LEARNER HAD ANY OPERATIONS?
YES
NO
IF YES, PLEASE GIVE DETAILS.
PLEASE SPECIFY ANY OTHER RELEVANT MEDICAL DETAILS.
SECTION 3 : LEARNER'S MEDICAL DETAILS - CONSENT
IN A CRITICAL MEDICAL SITUATION, PLEASE BEAR IN MIND THAT THERE MAY NOT BE TIME TO REFER TO THE LEARNER'S RECORDS. THE SCHOOL THEREFORE RESERVES THE RIGHT TO UTILISE THE QUICKEST MEDICAL SERVICE AVAILABLE.
I,BEING THE PARENT / LEGAL GUARDIAN OF
HEREBY AGREE THAT A MEDICAL PRACTITIONER MAY PROVIDE EMERGENCY TREATMENT AS MAY BE NECESSARY.
SIGNATURE OF PARENT / LEGAL GUARDIAN
SECTION 4 : DETAILS OF FATHER / STEPFATHER / LEGAL GUARDIAN
COMPLETE ONLY IF NOT THE ACCOUNT HOLDER. REFER TO SECTION 8.
SURNAME |
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FULL NAMES AS IN ID DOCUMENT |
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DESIGNATION |
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MR |
MRS |
MS |
MISS |
DR |
REV |
PROF |
OTHER |
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IDENTITY NUMBER |
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RELATIONSHIP |
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MARITAL STATUS |
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OCCUPATION |
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EMPLOYER |
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RESIDENTIAL ADDRESS |
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WORK ADDRESS |
POSTAL ADDRESS |
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CODE |
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CODE |
CODE |
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TEL H CODE |
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TEL W |
CODE |
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CELL |
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PARENTAL STATUS |
LEARNER LIVING WITH |
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LEARNER'S LEGAL |
ACCESS RIGHTS TO |
ACCESS RIGHTS IN AN |
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PARENT/S |
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GUARDIAN |
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LEARNER |
EMERGENCY ONLY |
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PAGE 3 OF 7
SECTION 5 : DETAILS OF MOTHER / STEPMOTHER / LEGAL GUARDIAN
COMPLETE ONLY IF NOT THE ACCOUNT HOLDER. REFER TO SECTION 8.
SURNAME |
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FULL NAMES AS IN ID DOCUMENT |
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DESIGNATION |
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MR |
MRS |
MS |
MISS |
DR |
REV |
PROF |
OTHER |
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IDENTITY NUMBER |
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RELATIONSHIP |
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MARITAL STATUS |
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OCCUPATION |
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EMPLOYER |
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RESIDENTIAL ADDRESS |
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WORK ADDRESS |
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CODE |
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CODE |
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TEL H CODE |
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TEL W CODE |
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CELL |
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PARENTAL STATUS
LEARNER LIVING WITH
PARENT/S
LEARNER'S LEGAL
GUARDIAN
ACCESS RIGHTS TO
LEARNER
ACCESS RIGHTS IN AN
EMERGENCY ONLY
SECTION 6 : DETAILS OF ANOTHER CONTACT IN THE CASE OF AN EMERGENCY
SURNAME |
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FULL NAMES |
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RELATIONSHIP |
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TEL H CODE |
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CELL |
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SECTION 7 : DECLARATION OF PARENTS / LEGAL GUARDIANS
We the undersigned, _________________________________________________________________, hereby certify that the information given by us
in this Application for Admission is complete and accurate. We also agree to the conditions as set out herein.
We accept that the School is based on Christian principles and undertake that this will not be undermined.
We understand that the prescribed number of learners per class may be exceeded through the placing of a current learner that has to repeat a grade.
This Application for Admission will be reconsidered in the case where important relevant information, which should be brought to the School’s attention, is withheld.
We have read the Code of Conduct, Substance Abuse Policy and Dress Code and will accept an offer of placement for our child at the School in accordance with the terms and conditions as set out therein. These documents, as amended from time to time, are available on the official website of the School at www.curro.co.za.
NB: The signatures of both parents and / or legal guardians are required where applicable.
____________________________________________________ |
____________________________ |
SIGNATURE OF FATHER / STEPFATHER / LEGAL GUARDIAN |
DATE |
____________________________________________________ |
____________________________ |
SIGNATURE OF MOTHER / STEPMOTHER / LEGAL GUARDIAN |
DATE |
PAGE 4 OF 7
SECTION 8 : DETAILS OF ACCOUNT HOLDER
SURNAME |
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FULL NAMES AS IN ID DOCUMENT |
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DESIGNATION |
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MR |
MRS |
MS |
MISS |
DR |
REV |
PROF |
OTHER |
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IDENTITY NUMBER |
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RELATIONSHIP |
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MARITAL STATUS |
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OCCUPATION |
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EMPLOYER |
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RESIDENTIAL ADDRESS |
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WORK ADDRESS |
POSTAL ADDRESS |
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CODE |
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CODE |
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CODE |
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TEL H CODE |
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TEL W |
CODE |
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CELL |
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PARENTAL STATUS |
LEARNER LIVING WITH |
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LEARNER'S LEGAL |
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ACCESS RIGHTS TO |
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PARENT/S |
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GUARDIAN |
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LEARNER |
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EMERGENCY ONLY |
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DETAILS OF CHILDREN IN YOUR CARE WHO ARE CURRENTLY AT THIS SCHOOL |
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1 |
NAME |
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GR |
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2 |
NAME |
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GR |
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3 |
NAME |
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NAME |
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ANNUAL, AFTER TAX, COMBINED |
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LESS THAN |
R 50 000 - |
R100 000 - |
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R150 000 - |
R200 000 - |
R250 000 - |
MORE THAN |
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HOUSEHOLD INCOME |
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R50 000 pa |
R100 000 pa |
R150 000 pa |
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R200 000 pa |
R250 000 pa |
R300 000 pa |
R300 000 pa |
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PLEASE NOTE: This is for statistical purposes only and will NOT affect your child's acceptance status.
PAYMENT OPTION
MONTHLY
DEBIT ORDER
MONTHLY IN ADVANCE BY
ELECTRONIC FUNDS TRANSFER OR CASH DEPOSIT AT THE BANK
ANNUALLY IN ADVANCE BY
ELECTRONIC FUNDS TRANSFER OR CASH DEPOSIT AT THE BANK
SECTION 9 : DECLARATION OF ACCOUNT HOLDER
We the undersigned, _________________________________________________________________, hereby certify that the information given by
the Account Holder in this Application for Admission is complete and accurate.
We accept joint and several liability to Campus and Property Management Company (Pty) Ltd and Meridian Operations Company NPC (RF) for the due and punctual payment of the annual,
We accept the Financial Terms and Conditions of which a copy has been kept.
NB: The signatures of the account holder and that of the 2nd parent / a parent / legal guardian are required if applicable.
____________________________________________________ |
____________________________ |
SIGNATURE OF ACCOUNT HOLDER |
DATE |
____________________________________________________ |
____________________________ |
SIGNATURE OF 2ND PARENT / A PARENT / LEGAL GUARDIAN |
DATE |
____________________________________________________ |
____________________________ |
SIGNATURE OF AN AUTHORISED SCHOOL REPRESENTATIVE |
DATE |
PAGE 5 OF 7