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APPLICATION FOR THE

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APPLICATION FOR THE Powered By Docstoc
					         APPLICATION FOR THE


   ACCELERATED
CHRISTIAN EDUCATION
                 PROGRAMME



    HOME EDUCATION




                    Individualised Education

    Pre School - Grade 12 ∙ Home Education ∙ Adult Literacy

   Tel (031) 573 6500 ∙ Fax (031) 569 1862 or (031) 569 1861/3
                PO Box 22072 ∙ Glenashley ∙ 4022
                   PLEASE COMPLETE THE FOLLOWING USING BLOCK LETTERS:

                                                                           DATE: ___________________________
To avoid duplication of school names, kindly submit 3 possible different names for your Home School in order of
preference: (Please do not use the word “Academy” in your home school name.)
a)     _______________________________________________________________________________________
b)     _______________________________________________________________________________________
c)     _______________________________________________________________________________________

______________________________________________________________________________________________
SCHOOL MAILING ADDRESS (incl. suburb and city)  POSTAL CODE     PROVINCE             COUNTRY
__________________________________________________________________________________________
SCHOOL STREET ADDRESS (incl. suburb and city)   POSTAL CODE     PROVINCE          COUNTRY
____________________________ ____________________________ ___________________________________
TELEPHONE                     FAX                          CONTACT PERSON

CELLULAR PHONE NO.: ____________________________ E-MAIL ADDRESS: ____________________________

FULL Name of Father: _________________________________________________________________________
                     First                Middle                     Surname

FULL Name of Mother: _________________________________________________________________________
                     First                Middle                     Surname

1.     Below, please fill in the names, ages and grade levels of your children who will be using the ACE
       programme:

                                                                   Last grade       Name of current or last
                  Name                Date of Birth      Age
                                                                  level passed         school attended

 1.1

 1.2

 1.3

 1.4

 1.5

2.     If the last school attended has been a school using the ACE programme (ACE school), kindly furnish the
       following information:

       2.1     State reasons for leaving the school: ________________________________________________
               ________________________________________________________________________________
       2.2     Are there any fees outstanding at the previous school? _________________________________
       2.3     Are you aware of any unresolved matters at the previous school? ________________________
               ________________________________________________________________________________
3.     A letter of release/learners transfer card from the school (ACE or public) your children previously
attended.
4.     We are interested in home schooling our children on the ACE programme because ________________
       _______________________________________________________________________________________
       _______________________________________________________________________________________
       _______________________________________________________________________________________
5.     We learned about the ACE home education programme through: _______________________________
       _______________________________________________________________________________________
6.       Do you belong to a denominational group?          YES _____________         NO _______________
7.       If independent, with which church do you fellowship? ________________________________________
         Fellowship address: _____________________________________________________________________
8.       Proposed date of starting your home school: ________________________________________________


                                    STATEMENT OF FAITH AND PRACTICE

9.       Doctrinal Position

         We believe in

         a)      The inspiration of the Bible in all parts and without error in its origin;

         b)      The one God, eternally existent Father, Son and Holy Spirit, Who created man by a direct
                 immediate act;

         c)      The pre-existence, incarnation, virgin birth, sinless life, miracles, substitutionary death, bodily
                 resurrection, ascension to Heaven, and the second coming of the Lord Jesus Christ;

         d)      The fall of man, the need of regeneration by the operation of the Holy Spirit on the basis of grace
                 alone, and the resurrection of all: to life or damnation;

         e)      The spiritual relationship of all believers in the Lord Jesus Christ, living a life of righteous works,
                 separated from the world, witnessing of His saving grace through the ministry of the Holy Spirit.

10.      I have read and agree with the Accelerated Christian Education Statement of Faith and Practice.

         YES ________________             NO ________________

         ______________________________            ____________________________               _________________
         Father’s Signature                        Mother’s Signature                         Date


11.      Give two references: (11a) Next of kin (11b) Preferably a pastor already involved with the ACE
         programme.
     11a ____________________________        __________________________________           ___________________
         Name                                Address                                      Telephone

     11b ____________________________        __________________________________           ___________________
         Name                                Address                                      Telephone

12.      Please give the name(s) of the person(s) whose actions influenced you to place application for the
         Accelerated Christian Education programme:
         ______________________________________________                     __________________________
         Name                                                               Telephone
         ______________________________________________                     __________________________
         Name                                                               Telephone
                                         OFFICE USE ONLY
                                                 Recommendation

        (Please complete this section before submitting the application for registration to National Office.)

1.      Name of Area Manager/Regional Representative / Consultant: ________________________________

2.      Name of Interviewer: ___________________________________________________________________

3.      Date on which application was received from proposed home school: ___________________________

4.      Name of host school/home educators academy: ______________________________________________

        Tel: ___________________________________           Fax: _________________________________________

        Postal Address: _________________________________________________________________________

        Physical Address: _______________________________________________________________________

5.      Recommendation: ______________________________________________________________________
        _______________________________________________________________________________________
        _______________________________________________________________________________________
        _______________________________________________________________________________________
        ___________________________________________________________________________________________
        ___________________________________________________________________________________________
        ___________________________________________________________________________________________
        ___________________________________________________________________________________________
        ___________________________________________________________________________________________
        ___________________________________________________________________________________________
        ___________________________________________________________________________________________
        ___________________________________________________________
(i)     Probationary Registration?               NO               YES
(ii)    Type of Training recommended?            Monitor          Supervisor           Home School Activity Pac
(iii)   Date of training course if monitor/supervisor: _______________________________________________
(iv)    Type of interview:           Personal          Telephonic              Reputable reference




        Signed: ___________________________                Date sent to National Office: __________________
Area Manager / Regional Representative / Consultant / Home Academy Advisor


Please ensure that this application is completed in detail, to the full. References are crucial for future use.


The following requirements / documents must accompany this application.
        Proof of Provincial/National Education Department registration.
        Home Educators Resource Kit Form (ticked with items needed for Starter Kit)
        Letter from previous school (Independent/Public).
                                                                                                     Edited 15/01/07

				
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Description: APPLICATION FOR THE