2016 Scholarship Application Form

Transcription

2016 Scholarship Application Form
APPLICATION FOR SCHOLARSHIP
REQUIRED SUPPORTING DOCUMENTS
Documents to be attached to this application should include:
2 x passport photographs
Certified copy of Birth certificate / ID document of the applicant
Certified copy of pupil's 3 most recent school reports
Supporting documentations (certificates of performance, records of achievement, letters of commendation)
Letter of motivation written by the applicant
TWO RECENT
COLOUR PHOTOS
OF LEARNER
NB: This is not an application for entry into Woodhill College
SECTION A : PUPIL'S PERSONAL DETAILS
SURNAME
FULL NAMES AS ON BIRTH CERTIFICATE / ID DOCUMENT
PREFERRED NAME
IDENTITY NUMBER
DATE OF BIRTH
Y Y Y Y
M M
D D
YEAR & GRADE APPLIED FOR
AGE
GENDER
YEAR
GRADE
HOME & OTHER SPOKEN LANGUAGE/S
HOME
OTHER
LANGUAGE OF LEARNING & TEACHING
FIRST
SECOND
NUMBER OF CHILDREN IN FAMILY
RELIGION
MALE
FEMALE
POSITION OF CHILD IN FAMILY
NATIONALITY
COUNTRY OF ORIGIN
SECTION B : PUPIL'S EDUCATIONAL DETAILS
PREVIOUS SCHOOL
1
PREVIOUS SCHOOL
PRINCIPAL
PRINCIPAL
ADDRESS
ADDRESS
2
CODE
TEL NO
CODE
LAST GRADE PASSED
CODE
TEL NO
YEAR
CODE
GRADE/S REPEATED
SECTION C : PARENTS' DECLARATION
We, The undersigned, ______________________________________________
________________________________________________________________________________ hereby certify that
the information given by us on this application is complete and accurate
_______________________________________________________
FATHERS NAME
__________________________________________________________
MOTHERS NAME
FATHERS TEL NO ____________________________________
_______________________________________
MOTHERS TEL NO ___________________________________________
FATHERS E-MAIL ADDRESS ___________________________
_______________________________
MOTHERS E-MAIL ADDRESS __________________________________
__________________________________________
FATHERS SIGNATURE
____________________________________________
MOTHERS SIGNATURE
__________
DATE
__________
DATE
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SECTION D : ACADEMIC ACHIEVEMENTS
SUBJECT
MARKS
2014 (promotion mark)
2013 (promotion mark)
English Home Language
Afrikaans First Additional Language
Other Language:
Mathematics
Life Orientation
Natural Science
Social Science
Arts and Culture
EMS
Technology
ACHIEVEMENTS IN ACADEMIC EXAMS / COMPETITIONS
NAME OF EXAM / COMPETITION
Date
Mark
SECTION E: SPORT OR CULTURAL ACHIEVEMENTS
ACHIEVEMENT / COLOURS / PROVINCIAL TEAM SELECTION / EXAM etc
Date
* Please attach all supporting documentation / certificates etc.
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