Virtual School Online Application

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Virtual School Online Application

Email *

Email

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How did you hear about our school?

Parent referral (please indicate parents name)
Facebook Advert
Google Search
School Signage
Referred by another school (please indicate school)
Other (please specify below)

Other comments

Please select for which grade you are applying *

Year applying for?

Grade 10 Subject Choices (if applicable)

Mathematics Core
Mathematics Literacy
Life Sciences
History
Visual Arts
Business Studies
Physical Science
Geography

Father / Guardian Information *

First

Last

ID Number (Father) *

Home Telephone (father)

Work Telephone (father)

Cell Number (father) *

Email (father) *

Email

Confirm Email

Home Address (father) *

Occupation (father)

Responsible for payment? (father) *

Yes
No

Mother / Guardian Information *

First

Last

ID Number (Mother) *

Home Telephone (mother)

Work Telephone (mother)

Cell Number (mother) *

Email (mother) *

Email

Confirm Email

Home Address (mother) *

Occupation (mother)

Responsible for payment? (mother) *

Yes
No

Student Name *

First

Last

Gender *

Male
Female
Prefer not to say

ID / Passport Number *

Cell Number

Current Grade *

Citizenship *

Home Language *

Home Address *

Age *

Student's primary residence

Current School *

Last grade passed *

Does the student have any of the following barriers to learning?

Attention Deficit Disorder
Autistic Spectrum Disorder
Behavioral Disorder
Cerebral Palsy
Epilepsy
Hard of hearing
Partially sighted
Physically disabled
Specific learning disability
Reading difficulties
Numeric difficulties
Auditory Processing Disorder
Other

If yes to any of the above, please give details.

Accomodation received from DBE?

Yes
No

If yes, please give details.

Is there any additional information we should know about your child?

Name