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APPLICATION FORM Please complete

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									St Stithians College | Private Bag 2 | RANDBURG | 2125 www.stithian.com
Tel: (011) 577-6100 Fax: (011) 789-8921 E-mail: PostMatric@stithian.com




                                                                          APPLICATION FORM
Please complete the application form below (ENTER THE REQUIRED INFORMATION IN THE GREY
RECTANGLES) and return this form, as soon as possible, along with the registration fee to:
St Stithians College, Admissions Secretary, Private Bag 2, Randburg, 2125 or E-mail this form as an
attachment to: PostMatric@stithian.com


APPLICATION FOR: A LEVEL COLLEGE
PART I: CHILD'S DETAILS (Please enclose copies of relevant reports)
     1.   Proposed Entrance Date:                Year:
     2.   Child's Surname:             Child's First Name(s):
     3.   Child prefers to be called:
     4.   Child's date of birth: (day/month/year)
     5.   Gender: Male             Female
     6.   Child's physical address:
                   Postal Code:
     7.   Child's Citizenship:            Country of birth:
     8.   Home language:              Religious denomination:
     9.   Race/Ethnicity (optional):
     10. Position in family: (eldest, youngest etc)
     11. Child's Official Parent/ Guardian: (Place an X where appropriate)
          Father           Mother            Stepfather             Stepmother
          Other
     12. Child lives with: (Place an X where appropriate)
          Father           Mother            Stepfather             Stepmother
          Other
     13. Name of current/previous school:
     14. Name of Head:
     15. Address & contact details of current school/College:
                   Postal Code:           Tel: Fax:
     16. Names, addresses & telephone numbers of two persons to whom references can be made.
          1.                                                   2.
     17. Any special requests or information?
     18. Does the child have any disabilities/physical/learning handicaps?




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St Stithians College | Private Bag 2 | RANDBURG | 2125 www.stithian.com
Tel: (011) 577-6100 Fax: (011) 789-8921 E-mail: PostMatric@stithian.com



                                                                          APPLICATION FORM
PART II: FAMILY DETAILS:


     1.   Is there a brother/sister in the school?
          Yes          No           On the wait list?
     2.   Sibling's First Names:
     3.   Current Grade of Sibling:                 House:
     4.   Father's Surname:             Initials:            Title:
                a.   Postal Address:


                             Postal Code:
                b.   Physical Address:


                             Postal Code:
                c.   Tel Home:            Business:              Cell:
                     Fax:          Email:
                d.   Occupation:
     5.   Mother's Surname:              Initials:            Title:
                a.   Postal Address:


                             Postal Code:
                b.   Physical Address:


                             Postal Code:
                c.   Tel Home:            Business:              Cell:
                     Fax:          Email:
                 (EMAIL ADDRESS FOR NEWSLETTER AND OTHER IMPORTANT COLLEGE CORRESPONDENCE)



            DETAILS OF RELATIONS WHO HAVE ATTENDED ST STITHIANS COLLEGE
             Name                             Years at Saints                Relationship to your child




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St Stithians College | Private Bag 2 | RANDBURG | 2125 www.stithian.com
Tel: (011) 577-6100 Fax: (011) 789-8921 E-mail: PostMatric@stithian.com



                                                                          APPLICATION FORM
     ST STITHIANS BOYS’ COLLEGE OFFERS BOARDING TO BOYS AND GIRLS IN THE A
                                                  LEVEL COLLEGE.
Do you wish your son to be a boarder?
The Headmaster stands in for all boarders. This is of great importance in the case of sudden illness. By
signing this application for the admission of their sons as boarders, parents empower the A Level Director
to act on their behalf in all emergencies. Boarders are required to return to the Boarding House early each
Sunday evening.


How did you hear about St Stithians?


I/We undertake to pay all fees in advance upon receipt of a statement and in the event of withdrawing my child from
the College, for any reason whatsoever, we undertake to give one full term’s notice or, alternatively, to pay one
term’s fees in lieu of notice.


The College expects parents to abide by all the school policies and co-operate with teachers and administrators. The
College also expects parents to require their children to uphold the Code of Conduct of St Stithians College.


1.           Date:
2.           Date:
Signature of both parents / guardians:


NB Attached to your application, please enclose the following:
1. A copy of the latest school report.
2. A confidential academic and conduct report from the Head of your child's present school.
3. A non-refundable registration fee of R250.00 is required.




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