J.G. MEIRING

APPLICATION FOR ADMISSION TO

J G MEIRING HIGH SCHOOL

021 591 3131 E-MAIL: headmaster@jgmeiring.co.za

FAX: 021 592 2920MERRIMAN ROAD,GOODWOOD,7460

Any information provided in this application which is found to be false or incorrect, will lead to the rescinding of the admission of this applicant.

Office use only Admin nr.:

...............................................

Grade / Class Section:

............................................... Final Decision:

……………………………………………

Date of admission:

_____ / _____ / 2018

Office use only

Applicant: Surname: ___________________________________ First name: ________________________

Grade at admission: ___________________Section: ____________ Principal: ____________________

Your child’s enrolment form will not be considered, unless it has been completed correctly (in full) and the following documentation is attached:

1. Unabridged birth certificate or ID document of learner.(Certified) 2. One passport photograph. 3. Latest report. 4. Proof of immunisation / Clinic card (Gr 8 & Gr 9 only) 5. Proof of residential address (BOTH municipal account AND lease contract). 6. I.D. document of both parents / guardians or death certificate where applicable. (Certified) 7. *If applicable: Non-South African citizens: certified proof from the Department of Home affairs that learner is legally allowed to reside in South Africa.(e.g.a temporary/study permit; refugee status).

8. Payslip (Both parents)

Office use only:

1. Birth certificate

2. Passport photo

3. Latest report

4. Proof of immunisation

5. Proof of residence

6. Parents/Guardian ID

7. *Non-SA citizen: proof

8. Payslip

A LEARNER’S PARTICULARS Surname: _______________________________________________ Grade for admittance: ________________

Full names: _____________________________________________ Name known by: ____________________

Date of birth: Day Month Year Sex: ______________________________ ________ / __________________ / ___________

ID number:

Present school:________________________________________________________________________________

Relationship to parent: Biological Adopted child Foster child Other details __________________

Learner’s address: ____________________________________________________________________________

Religious denomination: _______________________________ Home language: ____________________

Number of children in family: ________ Is learner the 1st, 2nd, 3rd, etc. child in the family?: __________________

Brother(s) / sister(s) at J.G. Meiring:

Name Surname Grade Section

B PARTICULARS OF PARENTS

Father

Mother

Title, initials and surname

ID number

Postal address

Home address(if different

from postal address)

E-mail address

Occupation

Employer

Telephone numbers

Home ( ____ ) ______________________________

Home ( ____ ) ______________________________

Work ( ____ ) ______________________________

Work ( ____ ) ______________________________

Cell _______________________________________

Cell _______________________________________

Marital status Married Divorced Separated Single

Combined annual income

Less than R200 000 p.a.

R350 000 – R500 000 p.a.

R200 000 – R350 000 p.a

R500 000 + p.a.

Field in which parent is prepared to assist the school, e.g. fund raising, library, sale of text books / stationery, sport coaching, catering, flowers, etc. Please specify:

__________________________________________________________________________________________________

__________________________________________________________________________________________________

Learner and Parent to sign

I understand the contents of the school’s code of conduct, substance abuse agreement and cell phone policy and agree to abide by them. Signed: _____________________ _____________________ ______________________ Learner Father Mother

C SUBJECT CHOICE

GRADE(S) 8 & 9

The following learning areas are compulsory:

English Home Language

Afrikaans First Additional Language

Mathematics

Life Orientation

Human and Social Sciences

Natural Sciences

Economic and Management Sciences

Technology

Creative Arts

GRADE(S) 10, 11 & 12

Please complete Annexure A [Subject choice Form].

NB Ensure that learner’s name is filled in on this form and that it is signed by the learner and parent.

D MEDICAL INFORMATION

Name of Medical Aid Society: __________________________________ Name of Main Member: ________________________

Medical Aid number: ________________________________ Any allergies: _____________________________________

Any prescribed medication: __________________________________________________________________________________ MEDICAL & PERSONAL HISTORY Please attach any relevant documentation regarding any ailment, disease or disability of which the school should be informed.

E REFUGEE STAUS

Date of immigration: _____________________________________ Country of origin: ___________________________________

Valid from: __________________ Expiry date: ___________________ Departmental exemption number: ____________________

F NOTIFICATION VIA SMS

Please supply the cell phone number of the person who is to receive messages from J.G. Meiring via SMS.

Name and surname: ____________________________ Cell no.:

G CONSENT INDEMNITY AND ACKNOWLEDGEMENT OF DEBT WITH RESPECT TO

SCHOOL FEES.

Consent and indemnity I hereby give my consent for my child to take part in extramural activities for the school, including educational excursions / tours, cultural and sports activities while attending this school. I fully understand and accept that my child’s participation in all tours, excursions and sports activities shall be undertaken at indemnity, hold harmless and absolve the Governing Body, Principal and Staff against any or all claims whatsoever that may arise in connection with my aforesaid child in the course of any such tour / excursion / cultural or sports activity.

Acknowledgement of debt We agree that both parents, father and mother, and/or guardian, are jointly and severally liable for the school fees as determined by statutory regulation annually, and that fees will be paid in accordance with the requirements set out from time to time by the school for the duration of our/my child’s school career at J.G. Meiring High School. Mandate to gather personal information We understand the school’s right to seek confidential information regarding personal finances and income and agree to the above when application for financial relief is applied for. Signatures: ___________________________________________ __________________________________________

Father/ Guardian (Delete whichever is not applicable) Mother/ Guardian (Delete whichever is not applicable)

_________________________________ ________________________________

School representative Date

SPECIMEN SIGNATURES

_____________________ _____________________ ______________________ Father Mother Guardain

N.B The first round of applications for admission closes on the first Friday in June. The final round of applications closes on the first Friday of the last school week in September. It is thus extremely important that all applications from within the catchment area are received timeously to avoid disappointment.

H APPLICATION AT OTHER SCHOOLS

Have you applied at any other schools? If YES, list the schools at which you have applied:

a) __________________________________________

b) __________________________________________ c) __________________________________________ Which is the closest school to where the learner resides?

a) __________________________________________

Your child’s enrolment form will not be considered, unless it has been correctly completed and

all the relevant documentation is attached.

SCHOOL CONSELLING INFORMED CONSENT J.G. MEIRING HIGH SCHOOL

Dear Parent/Guardian J.G. Meiring High School offers short-term individual counselling to students. One registered counsellor, registered with the Health Professions Council of South Africa, offer this service, Ms.Le Fleur Parents/guardians or school staff may refer students for counselling, or students may request counselling. It is the policy of the Health Professions Council of South Africa to obtain parent/guardian written permission for counselling to take place. The bottom portion of this consent form may be attached to your child’s application form. School counselling services are short-term services aimed at the more effective education and socialization of your child within the school community. These services are not intended as a substitute for diagnosis or treatment for any mental health disorder. In order to build trust with the child, the school counsellor will keep information confidential, with some possible exceptions. Because these services are provided to minor children in the school setting, the school counsellor may share information with parents/guardians, the child’s teacher, and/or administrators or school personnel who work with the child on a need to know basis, so that we may better assist the child as a team. The school counsellor is also required by law to share information with parents or others in the event that the child is in danger of harm to self or others. The school counsellor will make the child aware of these limits to confidentiality and will inform the child when sharing information with others. If you would like the counsellor to share information with a third party, such as a community counsellor, psychiatrist, social services worker, or paediatrician, you will need to sign an additional release of information form. We hope you child will enjoy and benefit from the services we offer, and we encourage you to contact us whenever you have a question, input or concern, or would like an update on your child’s progress in counselling. Child’s Name ___________________________ I, ______________________________________, am the legal parent/guardian of __________________________. I have read, understand, and agree to the terms of the attached School Counselling Informed Consent. Please check one: I give permission for my child to receive school counselling services at J.G. Meiring High School if deemed necessary. I understand that I may withdraw my consent at any time by signing and dating a written note requesting termination of counselling services. I choose to decline school counselling services for my child at this time. I understand that I may request counselling services at a later date if needed. Parent/Guardian (Signature) _____________________________ Date: _______________________ Phone: Daytime contact number: ______________________ E-mail: _________________________________

Cell phone: ____________________________

JG MEIRING HIGH SCHOOL: Counselling Service

Dear Principal

A learner from your school has applied to JG Meiring High School. Kindly complete Section B of this

assessment below as soon as possible, as it forms part of the Application. Please fax it directly to the

school (fax no. 021 592 2920) OR return it via the applicant in a SEALED ENVELOPE.

_____________________________________________________________________________________

SECTION A

Name of learner: ______________________________ Surname: _______________________

Present School: _____________________________________ Grade: ____________

Contact numbers of Parents: Father: ____________________ Mother: ___________________

_____________________________________________________________________________________

SECTION B – For completion by the school Principal.

Contact numbers of present school: Tel: ______________________ Fax: _____________________

Does the learner’s academic performance reflect his/her capability? Yes ( ) No ( )

This learner’s academic results fall into the (TOP) (MIDDLE) (BOTTOM) third of his/her Grade.

Were the learner’s parents involved in and/or supportive of the school’s intervention programme?

Yes ( ) No ( )

Please specify: ________________________________________________

Has the learner been tested by the SLES of the WCED for any learning barriers? Yes ( ) No ( )

Remarks: -------------------------------------------------------------------------------------------------------------------

_____________________________________________________________________________________

1. DISCIPLINE

Has any disciplinary action been taken against the learner for the following offences? Please indicate.

Disruptive in class Books left at home Swearing

Insolence Stealing Smoking Cigarettes

Work not done Dealing in / taking drugs Bullying / Fighting

Gang-related activities Vandalism Late coming

Has the learner ever been suspended? YES ( ) No ( )

Has the learner been expelled? YES ( ) No ( )

2. SKILLS

Please rate the above-mentioned learner on the following scale:

5 = Excellent 4 = Good 3 = Average 2 = Weak 1 = Very Weak

WORK SKILLS SOCIAL SKILLS

Concentration Self-control

Independence Acceptance of responsibility

Listening skills Interaction with peers

Following instructions Group participation

Task completion Courtesy

Presentation of work Behaviour

Meeting deadlines Respect for superiors

Proficiency in English Appearance

Proficiency in Afrikaans Reliability

Proficiency in Mathematics Problem solving ability

Study habits Adherence to Code of Conduct

Reading ability Leadership skills

3. SCHOOL FEES

Are the school fees currently up to date? YES( ) NO( ) Amount outstanding: R

4. INVOLVEMENT IN SCHOOL LIFE

Please rate the above-mentioned learner on the following scale:

5 = Excellent 4 = Good 3 = Average 2 = Weak 1 = Very Weak

Attendance at school Attendance at Extra murals Culture Sport Societies

5. GENERAL INFORMATION

Any areas in which the learner has excelled: _______________________________________

Any other remarks:

Thank you for completing this form

PRINCIPAL’S NAME: ___________________ SIGNATURE:___________________

DATE: ________________________________

SCHOOL STAMP:

NB: This form is for use by the Counselling Service of JG Meiring only.

Acc

UNDERTAKING TO PAY TUITION FEES FOR 2018

According to the South African Schools Act No.84 of 1996, tuition fees are legally payable on the first school day of

the year. The Governing Body has granted a concession which allows you to pay tuition fees in instalments.

Learner: Surname Name Grade

We/I the abovementioned parent(s) hereby agree to pay the tuition fees for the year 2018to the Governing Body of

J.G. Meiring High School as follows:

CIRCLE YOUR PAYMENT CHOICE:

A The full amount before the 31 March 2018 (Discount of 5% per learner for full settlement);

B Per debit order from February until 1 November 2018 - (A debit order application is attached for your

convenience);

C In monthly instalments from January 2018 before or on the last day of each month with the last and

final payment before or on 1 November 2018;

Should we/I fail to comply with my choice of payment as indicated above, the full outstanding amount becomes

claimable and payable. Should attorneys/debt collectors be appointed to recover my outstanding debt, I hereby agree

to pay all costs between the attorney / debt collector and his client, as well as any collection commission which may

be payable.

Should any or all of the learners, for whom I am responsible, leave the school during the course of any month or term,

I undertake to pay all outstanding tuition fees for the learner(s) on the last school day before a transfer form (if

applicable) can be issued, unless the Governing Body has made special arrangements with me in writing.

Reduction in school fees:

Learners in financial need are entitled to a reduction in school fees. Application forms are available at the school. Applications

must reach The School Governing Body before / on 31 January 2018. If application forms are incomplete they will not be

considered.

Signed at _________________________ on this ______ day of __________________ 20_____ .

SIGNATURE OF PARENT/GUARDIAN: ________________________ _______________________

Parent / Guardian 1 Parent / Guardian 2

Banking Details: ABSA cheque account 062075007 Branch code: 632005

Please use the learner’s Account number and fax proof to: 086 636 2136

PARTICULARS OF PARENTS

Father or Guardian Mother or Guardian

Title, initials and surname

ID number

Home address

Tel. number

E-mail address

DEBIT ORDER

Account Holder Details:

Parent: Surname

Home Address

E-mail Learner: Surname Learner: First Name

Tel (Home)

Tel (Work)

Cell

Bank Details:

Account Holder:

Bank:

Branch Name:

Branch Code: First Payment date: ________/02/2018

Account Type: Cheque Savings Transmission

Account No:

Debit Order processing:

All Debit orders are processed from February to 1 November.

NB: Please note that where applicable day falls on a weekend or public holiday the debit order will be processed on the

following working day.

I, the undersigned, hereby authorize J.G Meiring High School to withdraw the above amount from my bank account.

I/We acknowledge that the party hereby authorised to effect the drawing(s) against my/our account may not cede or assign any of

its rights to any third party without my/our prior written consent and that I/we may not delegate any of my/our obligations in

terms of this contract/authority to any third party without prior written consent of the authorised party.

__________________________________

Please print Name:

_________________________________ ________________________

SIGNATURE OF ACCOUNT HOLDER DATE

Acc

Debit Order Amount

Grade

J G MEIRINGHIGH SCHOOL

021 591 3131 E-MAIL: headmaster@jgmeiring.co.za

FAX: 021 592 2920MERRIMAN ROAD,GOODWOOD,7460

Name of learner: _________________________Gr. & Section: _________ Date of birth:____________

Dear Parents

CO-CURRICULAR PARTICIPATION – 2018

As you know, from January 2018 it is compulsory for a learner to take part in at least one summer sport and

one winter sport. In the column below please indicate what sport your child is going to participate in. Your

child must attend all practices and matches. If, for reasons of illness or injury, he/she is not able to

participate in a practice or match, please provide him/her with a note or a doctor’s certificate.

SUMMERSPORT INDICATE WITH X

ATHLETICS(Specify event)

CRICKET

TENNIS

SWIMMING

WINTERSPORT INDICATE WITH X

NETBALL

HOCKEY (BOYS)

HOCKEY (GIRLS)

RUGBY

SOCCER (BOYS)

SOCCER (GIRLS)

CHESS

TABLE TENNIS

CHOIR

DRAMA

MUSIC (Specify Instrument)

Yours sincerely

______________________

T LINDERTS

HEADMASTER

DECLARATION BY PARENT / GUARDIAN

I, _________________________________________ have taken note of the contents of this Circular and

agree to abide by the conditions set out therein. I also undertake to ensure that my child attends all practices

and matches.

SIGNATURE OF PARENT/GUARDIAN: ______________________________ DATE: _________________

SUBJECT SELECTION FORM

LEARNER: _________________________________ Grade: 10 / 11 / 12

Selection subjects is a serious matter. Parents/guardians and learners are reminded that learners will not be allowed to change

their subjects without consultation, as the school orders textbooks and arranges the timetable based on these subject selections.

Furthermore, changing subjects will depend on the availability of space in that classroom and various other factors. It is in this

light that it is so important to make an informed decision which matches not only the learners’ career path but also their

scholastic ability.

You are requested to select one subject from each group and to indicate it clearly with an “X”. If any alterations are made on the

form, the parent/guardian and the learner are required to initial next to the alterations.

Group Subject Gr 10 Gr 11 Gr 12 PEC Code

Group 1: Home Language English Home Language

(1) X X EH 11

Afrikaans Huistaal(1)

AHT 12

Group 2: First Additional Language Afrikaans (EersteAdditioneleTaal)

(1) X X AAT 21

English (First Additional Language) (1)

EFAL 22

Group 3: Mathematical Sciences Mathematics MAT 31

Mathematical Literacy MLIT 32

Group 4: Life Orientation Life Orientation (1)

X X X LO 41

Group 5

History HIS 51

Physical Science* (Mathematics compulsory)

SCI 52

Computer Applications Technology (2)

CAT 53

Geography GEOG 54

Group 6

Life Sciences LS 61

Business Studies BUS 62

Computer Applications Technology (2) CAT 63

History HIS 64

Group 7

Geography GEOG 71

Accounting ACC 72

Visual Arts (3)

VIS 73

Consumer Studies (4)

CON 74

Life Sciences LS 75

N

O

T

E

S

*If a learner would like to take Physical Science, it is compulsory to take Mathematics also. (1)

Compulsory subject. (2)

Subject does not count for University entrance. (Limited space based on the availability of computers.) (3)

Limited space and learners will have to undergo a selection process. (4)

Limited space as it involves a practical component

We, the undersigned, would like to request J.G. Meiring High School to implement the subject choices made. We have read this

document, and understand that these choices are subject to certain conditions and that we are not entitled to change our

selection, as it can negatively impact on the management of the school.

_______________________________ ________________________ ________________________

Signature (Parent / Guardian) Date Signature (Learner)