APPLICATION FOR THE
W
Description
APPLICATION FOR THE
Document Sample


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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