Windy Heights Primary

Admission Form

Learner's Personal Information

First Name

Last Name

Date of Birth

Gender

Identification No

Race

Country of Residence

Province of Residence (if SA)

Citizenship

Physical Address

Code

Home Telephone

Emergency Telephone

Learner Cell

Learner Email Address

Home Language

Preferred Language of Instruction

Religion

Deceased Parent

Mother

Father

Both

Death Certificate (if applicable)

Copy of Immunisation Records

Copy of Birth Certificate

Progress Report from Previous School

Transfer Letter from Previous School

Learner Medical Information

Medical Aid Number

Medical Aid Name

Medical Aid Main Member

Doctor's Name

Doctor's Address

Doctor's Telephone Number

Medical Condition

Special Problems Requiring Counseling

Dexterity

Registered for Social Grant

Parent / Guardian Information

Title

Initials

Surname

First Name

Gender

Home Language

Race

Identification No. OR Passport Number

Account Payer

Residential Street Address

City/Suburb

Code

Occupation

Employer

Surname of Spouse

First Name of Spouse

Occupation of Spouse

Learner Resides with This Parent

Spouse ID No.

Relationship to Learner

Marital Status of Parent

Admission Form

Learner's Personal Information

Previous School Information

Learner Medical Information

Sibling Information

Siblings

Parent / Guardian Information

Correspondence Details

Other Contact Details