AMITY INTERNATIONAL SCHOOL ERASMIA PRETORIA A PART OF A LEADING EDUCATION GROUP ADMISSION FORM REGISTERED WITH GAUTENG DEPARTMENT OF EDUCATION
ADMISSION POLICY 1. All learners will be enrolled, regardless of race, colour, creed, gender or religion. 2. All learners admitted to the school for the first time will write a test to assess their competencies in Mathematics and English. This would be done in the interest of the learner to establish whether there are gaps in the learner s knowledge for the grade intended. 3. A non-refundable enrolment fee will be payable for a learner attending the school as a new enrolment. 4. The decision of the Board of Management of the school whether to accept or decline an application for enrolment will be final. 5. All siblings linked to the school will obtain preferential admission. 6. After the quota of a class has been filled, other learners will be placed on a numbered waiting register. These learners will be admitted once place becomes available. 7. Amity International School is an academic school with the majority of learners attaining access for admission to a Bachelors Degree. 8. The following are required with the admission form: Certified copy of Birth Certificate Certified copy of Immunisation Card Last School Report Certified copy of both Parents Identity Documents R300 Admission Fee 9. The original transfer form/card and the original previous year-end or term end report must be presented to this school as soon as available, if the learner is accepted, but not later than the 1st day of the new school year/term. 10. Please ensure that you provide certified copies where required, as originals will not be accepted, but must be presented for confirmation. Please write full name in capital letter I, hereby accept the conditions of the Admission Policy of Amity International School. Signature Date:... 1
SECTION 1 LEARNER INFORMATION (As reflected on ID or Birth Certificate) Surname First Name/s in Full Preferred Name Date of Birth ID No. Country of Birth If not born in SA, date of entry to SA Religious Denomination Home Language Learner s cell phone number (if available) Race Name, address, telephone and fax number of present school: Tel ( ) Fax ( ) Present grade Language of instruction at present school Grade applied for Cultural activities participated in Sports activities participated in Leadership Positions 2
SECTION 2 FAMILY INFORMATION FATHER/GUARDIAN If guardian, state relationship with learner MOTHER/GUARDIAN If guardian, state relationship with learner Title (Dr/Mr/Mrs/Miss/Ms) Relationship to Learner (Applicant) Surname First Name Identity Number/ Passport Number Occupation Name of Employer/ Company Street Address of Business Business Telephone Number Residential Address (including suburb) Code: Code: Fax Number Postal Address Code: Code: Home telephone Number Cellphone Number E-mail Address Learner is living with: both parents / father / mother / legal guardian (circle that which is applicable) Physical address where learner is currently living Marital status (parents): married/widow/widower/divorced/judicially separated/single parent (circle that which is applicable) Number of children in family (Female Male ) Ages: (Female Male ) Code 3
SECTION 3 CHOICE OF FOREIGN & VERNACULAR LANGUAGE (Tick appropriate box) FRENCH HINDI TAMIL GUJARATI SECTION 4 MEDICAL INFORMATION Medical Aid Name Name of Principal Member Doctor s Name Medical Aid Number ID No. of Principal Member Doctor s Telephone No: Known medical problems (e.g. asthma, allergies, diabetes, epilepsy, etc.) Special needs of learner (e.g. wheelchair use, etc.): Contact details of person/s to contact in case of a MEDICAL EMERGENCY (when parents are not available) Name Relationship to learner Tel H( ) W( ) Cell 4
SECTION 5 FINANCIAL OBLIGATION Tuition Fees are payable as per TUITION FEE AGREEMENT 2014 and thereafter for each year of tuition at Amity International School with adjustments, if any, as communicated by the school to parents/guardians. Kindly Print Person responsible for payment of fees ID Number Postal Address SIGNATURE: (of person responsible for fee payment) Postal Code I/We accept responsibility for payment of fees: FULL NAME AND SURNAME: ID NO. OF ABOVE PERSON: WORK TEL NO. FOR ABOVE PERSON: STATE MOTHER/FATHER/GUARDIAN: FULL NAME AND SURNAME: ID NO. OF ABOVE PERSON: WORK TEL NO. FOR ABOVE PERSON: STATE MOTHER/FATHER/GUARDIAN: BANKING DETAILS Account Name: Bank: ABSA Branch: QUAGGA CENTRE Branch Code: 632005 Account Number: 4081982920 5
SECTION 6 DECLARATION NAME OF LEARNER I/We the undersigned hereby contract and agree that, should our child be accepted as a learner at Amity International School, the following will apply: As parent/guardian and learner, we undertake to support the School fully and abide by its rules and regulations as contained in this application form, Code of Conduct and any others as laid down by the Principal, Deputy Principal and the Board of Management. FEES: All school fees, as fixed by the Board of Management of Amity International School from time to time are payable monthly in advance, not later than the 7th of each month; and we undertake to pay interest at the prime rate on all school fees and disbursements in arrears. Upon acceptance of the above learner, a fee of 100% of one month s tuition is payable. A statement prepared and presented by the school showing the amount owing by us to the school shall be sufficient and satisfactory proof of the amount due by us to the school. NOTICE: A full month s notice of withdrawal of the learner from the school is required in writing or, in lieu thereof, we agree to pay a full month s fees before removing the above mentioned learner from Amity International School. (This does not apply to the final term of a learner s Matric year, but DOES apply at any other time, INCLUDING the end of the primary school phase.) RULES: All learners are subject to the system of discipline and the rules of the school as expressed in the Learner s Code of Conduct and as determined further by the School Management. WITHDRAWAL: Should a learner be withdrawn or expelled from the school, I/We accept that I/We shall remain responsible for all fees and disbursements for the month in which the learner is withdrawn. IN LOCO PARENTIS: At all times during school terms we authorize the Principal to act In Loco Parentis including granting consent for medical treatment, operations and anesthetics. The exact interpretation of this phrase in any emergency must be at the discretion of the Principal (or his/her appointed deputy), who will consult the parents whenever possible. INDEMNITY: I/We hereby agree that while the said learner is enrolled at Amity International School and is conveyed or transported at any time for any purpose whatsoever, it shall be at ours and the learner s own risk. We understand this to mean that we agree to allow the learner to b e t r a n s p o r t e d o r c o n v e y e d o n t h e understanding that, while all reasonable care shall be taken to ensure the safety of the learners, the school, parents who are acting for the school or individual employees of the school, shall not be liable in law to the said learner for any damage arising out of bodily injury to the learner. Likewise, should we become liable to pay medical or other expenses to any third party as a result of bodily injuries suffered by the said learner as foresaid, we understand that we will have no claim against Amity International School or any individual. INSURANCE: It is the responsibility of the parents/guardians to ensure that all personal belongings of the said learner are adequately insured against loss, as the school cannot be held responsible for loss or damage to the personal property of the learner. 6
I/We hereby give consent for my/our child /ward to take part in co-curricular and extra-curricular activities of the school, including games, athletics, educational tours and other excursions in the interests of the learner s development. I/We fully understand and accept that all tours and excursions shall be taken at my/our child s/ward s own risk and undertake on behalf of myself, my executors, my wife and my child/ward aforesaid to i n d e m n i f y, h o l d h a r m l e s s a n d a b s o l v e Amity International School Board, Parent Committee, Management of Staff, the Principal, Staff, the owners/drivers of private vehicles and coaches assisting the school, against and from any or all claims whatsoever that, my child/ward aforesaid may incur in the course of any such tour or excursion, in the knowledge that the Principal, other assistants and the staff will, nevertheless, take all reasonable precautions for the safety and welfare of my child/ward. Signature (Mother) Signature (Father) Signature (Learner) Date: Date: Date: 7
SECTION 7 FOR OFFICE USE ONLY Date of Receipt of Forms: Date of Interview: Approved: Not Approved: Reason if not approved: Admission Number: Admission Date: List of forms/documents not received on admission Principal Signature Financial Administrator Signature Date Date School Stamp 8
FEE STRUCTURE 2014-15 Grade Fee R R 9,000 1 to 3 R 21,780 4 to 9 R 22,990 10 to 12 R 23,595 9
Dear Parent/Guardiant Congratulations on choosing Amity International School for your child's education! We are confident that the years ahead will confirm that you have made a wise choice. Please spend a few movements to tell us how you came to learn of Amity International School by choosing from the options below: Newspaper/Print Media Name of Publication: Outdoor Advertising eg. billboard Location: Flyer/Brochure Where received: By "word of mouth" Relationship to individual: Other (Please specify): 10
AMITY INTERNATIONAL SCHOOL ERASMIA PRETORIA 647 Elzine Street, Erasmia, Pretoria For Admissions, please contact: Tel: 012 370 3706, 082 926 8819 Fax: 086 515 3494 I Website : www.amity.za.com Email: info@amity.za.com