nurturing minds

INSPIRING FUTURES

Online Application Form

click below for link & payment details
Full Name *

Gender

 *
Phone Number *
Email address *
Date of birth *
City/Suburb *
Postal Code
Province
Mother
Mother`s Contact Number
Father
Father`s Contact Number

Marital Status

Family Doctor
Doctor`s Contact Number

Does the student have any allergies,special needs or defects

Specify
Med Scheme
Med Aid Number
Med Aid Expiry Date
1st Emergency Contact Name *
Relationship to child *
Emergency Contact number *
2nd Emergency Contact Name *
Relationship to child *
Emergeny Contact number *
Child Name *
Child ID/Passport number *
Child Age *
Applicant Certified ID *

Max file size (Mb): 2

Max number of files: 1

Parent Certified ID(if not applicant) *

Max file size (Mb): 2

Max number of files: 1

Child Certified ID *

Max file size (Mb): 2

Max number of files: 1

Child Clinic Card/Immunization Record *

Max file size (Mb): 2

Max number of files: 1

Proof of payment *

Max file size (Mb): 2

Max number of files: 1

please note upon filling the online contact maybe made for  additional information

Click below to download PDF form,please submit the form with the following documents

  • Certified Copy of Applicant

  • Certified Copy of parent(if not parent)

  • Clinic card/Immunization record

  • Proof of payment