201 … APPLICATION FOR SUBSIDY - GRADE R CLASS

COVERSHEET
201…
APPLICATION FOR SUBSIDY - GRADE R CLASS
Name of school
Term 1 2 3 4
District
EMIS NO
COVER SHEET
Have you completed and included the following documentation with your application?
Documents attached:
(check your documents by ticking each block)
Annexure
A
Annexure
C
Annexure
D
One
Annexure for
all the Grade
R expenses.
Attach
Annexure C1
One
Annexure for
all Grade R
classes.
Annexure
B
This is a
SUMMARY
One
One
Annexure per
Annexure for
Grade R class.
all the Grade
R classes.
Registers
CEMIS
One per
Grade R class One list per
Grade R
from the
class.
previous
subsidy date.
Salary
Advice
UIF & SARS
Proof of
payment to
One advice
the relevant
per Grade R
departments
educator.
for these
amounts.
.
Receipts
for
purchases
Attach all
receipts to
Annexure C 1.
Complete for Grade R practitioners / educators only:
TEACHER INFORMATION - please print
Teacher 1
Full Name…………………………………………………….. ID No…………………………………
Teacher 2
Full Name…………………………………………………….. ID No…………………………………
Teacher 3
Full Name…………………………………………………….. ID No…………………………………
Teacher 4
Full Name…………………………………………………….. ID No…………………………………
Principal :
Date
Thank you for your co-operation
ANNEXURE A
201
APPLICATION FOR PAYMENT OF SUBSIDY – GRADE R CLASS
Term 1 2
3
4
COLLECTION OF SCHOOL FEES?
NQ 1 2 3 4 5
PARTICULARS
Name of institution:
NO
YES
EMIS NO:
Street
address:
Postal
address:
Postal code
Postal code:
Education district:
Circuit:
Full Name of principal:
Telephone number:
Code
number
FAX
Email address:
ENROLMENT / INSKRYWING:
Summary of all pupils in Grade R in the
school
Age (no learners younger than 4½ years old)
Boys
Girls
Total
4½ turning 5 years old this year: born between January and June
5 turning 6 years old this year:
born between January and December
6 turning 7 years old this year:
attach exemption letter to this form
Total
Number of Grade R classes
Circle
1
2
3
4
5
Number of learners per class
SIGNATURE OF PRINCIPAL
APPLICATION FOR SUBSIDY:
DATE
RECOMMENDED
/
NOT RECOMMENDED
DCES:ECD
CIRCUIT MANAGER _____________________________________________
DATE ______________________
IMG HEAD: _____________________________________________
DATE ______________________
6
7
8
ANNEXURE B
201
APPLICATION FOR PAYMENT OF SUBSIDY – GRADE R CLASS
Term 1 2 3 4
Name of institution:
Grade R Class Name
Address of institution:
Commencing date of quarter/
Closing date of quarter/
Total number of days on which school was held/
(PLEASE ATTACH A COPY OF ATTENDANCE REGISTER FROM THE LAST CLAIM DATE )
Indicate dates on which institution was closed during quarter/
Surname and Initials of learner
Date of Birth
Maximum claim 30 learners per class
Surname
Initials
Attach
EXEMPTION FORM if applicable
Day
Month
Date of admission of
learner to Institution
Year
If a learner left
during the term,
state the date of
withdrawal from
institution/
Number of days on
This column to be left
which learner
blank for Departmental
actually attended the
use/
.
institution during the
term/
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
I certify that the above particulars are derived from the enrolment and attendance registers maintained in accordance with the
requirements of the Western Cape Education Department and that the particulars are true and correct.
Signature on behalf of Governing Body/
Name in print/
Capacity/
Place/
ANNEXURE C
201
GRADE R CLASS/ES: FINANCIAL STATEMENT OF RECEIPTS AND EXPENDITURE
Term
Name of institution:
Registration number: (WCED Certificate Number)
Commencing date of quarter
Closing date of quarter
INCOME This is money that has been received
Description
Amount
Date
When was money
received
Where did the money come from
Balance Brought Forward
Explanation
How much money
was received
Fill in that amount here
WCED Subsidy
Did you receive further payment
from WCED? Fill that in here
R
Remember: this amount has to last
for the next 2 terms
School fees
Date
When was money
spent
How much money was left from the
last subsidy payment?
R
EXPENDITURE This is money spent
Description
Amount
Educator/s Salary (80% of
subsidy)
Month
How much money has been raised
this term?
R
R
2
R
3
1.
LTSM
Sponsorship
Do you receive any financial support
from other sources?
R
Total R
More than 4 educators? Use
an additional form.
-
UIF is deducted every month
SALARY TOTAL
(10%)
R
R
LTSM TOTAL
Claim running costs of Grade
R class/es if necessary.
R
TOTAL EXPENDITURE -
R
Subtract 4. TOTAL EXPENDITURE from
TOTAL INCOME
Telephone
R
R
This is the amount to be carried
forward to next subsidy application.
Water & Electricity
R
Copying & Printing
R
Cleaning materials
R
Maintenance
R
3. TOTAL FROM OTHER
R
OTHER
Signature:
Date:
Capacity:
Attach RECEIPTS to this
application
R
TOTAL INCOME
Drafted by: (full name)
This is all equipment &
materials used in teaching
Furnish RECEIPTS to prove
expenses have been paid.
- Attach Annexure C1 for expenses here
Insert Annexure C1’s total/s at 2. LTSM
TOTAL
2.
CLOSING BALANCE
Fill in the Gross Salary of the
teacher here
Include top-ups &
allowances etc This should be
reflected
on educator’s salary advice.
R
1
less UIF of 1%
Fundraising
Explanation
How much money
was paid
Who was paid with this money
How much money has come in this
term in school fees?
R
1 2 3 4
(10%) – Attach receipts
4. TOTAL EXPENDITURE
Add totals 1+2+3= 4
R
We the undersigned, hereby certify we have verified all the books and statements relating to the above entries and confirm that this statement is a true reflection thereof.
Signature of the Principal:
Full Name in Print:
Date:
Signature of the Chairperson of the School Governing Body
Full Name in Print:
Date:
ANNEXURE C1
201…
GRADE R EXPENSES SPREADSHEET
NAME of SCHOOL:
Date
17
10
13
Page___ of ___
ATTACH ALL RECEIPTS TO THIS SHEET
GRADE NAME:
TERM 1
2
3
4
Item and quantity
Name of Supplier
Receipt number
For what purpose will this material be used? eg
classroom, office, cleaning, telephone, electricity etc
Amount paid
3 reams white A4 paper
Pick 'n Pay
33479
Classroom
R 90.00
▲SEE EXAMPLE ABOVE ▲
▲SEE EXAMPLE ABOVE ▲
▲SEE EXAMPLE ABOVE ▲
TOTAL
Completed by :
(Print full name )
Signature of the Principal:
Signature:
Date:
Signature of the Chairperson of the Governing Body
Full Name in Print:
Full Name in Print:
Date:
Date:
ANNEXURE D WCED 096
201…
CERTIFICATE OF SOUND FINANCIAL MANAGEMENT
Term 1 2 3 4
Name of Educational Institution: ________________________________________________
Type of Educational Institution:
Public
High
Other
F
F
F
Independent F
Combined
F
Primary
F
Preprimary F
……………………….
Education District: ____________________________
CEMIS NO.: __________________
NUMBER OF QUALIFYING GRADE R LEARNERS AT SCHOOL THIS TERM
YES
NO
THE SCHOOL FUNCTIONS ACCORDING TO THE S.A. SCHOOLS ACT 1996 (Act 84/ 1996)
We, the undersigned, hereby certify that the institution implements effective, efficient and
transparent financial management and internal control systems (Section 38(1)(j) of the Public
Management Finance Act, 1999 (Act 1/1999 as amended by Act 29/1999).
CHAIRPERSON OF GOVERNING BODY
FULL NAME
DATE
SIGNATURE
print
PRINCIPAL OF INSTITUTION
FULL NAME
(print
SIGNATURE
DATE
SURVEY 2014
SURVEY
: NEW ANNEXURE FORMAT
SURVEY 2014
SURVEY
: NEW ANNEXURE FORMAT
1 = difficult to complete
2 = some parts were difficult to understand
3 = about the same as the previous forms
4 = easier to complete
5 = clear, simple and easy to complete
WE VALUE YOUR INPUT IN AN ATTEMPT TO MAKE THESE FORMS AS USERFRIENDLY AS POSSIBLE.
1 = difficult to complete
2 = some parts were difficult to understand
3 = about the same as the previous forms
4 = easier to complete
5 = clear, simple and easy to complete
WE VALUE YOUR INPUT IN AN ATTEMPT TO MAKE THESE FORMS AS USERFRIENDLY AS POSSIBLE.
NAME OF SCHOOL:
NAME OF SCHOOL:
1
2
3
4
5
Comments
1
COVER SHEET
COVER SHEET
ANNEXURE A
ANNEXURE A
ANNEXURE B
ANNEXURE B
ANNEXURE C
ANNEXURE C
ANNEXURE C1
ANNEXURE C1
ANNEXURE D
ANNEXURE D
SUGGESTIONS:
SUGGESTIONS:
2
3
4
5
Comments