Registration

Please Upload ID Photograph

Grade Applied For :

Highest Grade Passed :

Year Which This Grade Was Passed :

Present Grade :

Surname :

Initials :

First names :

Other Names :

Nickname :

Date of Birth :

Place of Birth :

Gender

Female

Male

Country of Residence :

If South African Indicate Province :

Citizenship :

ID number :

Street address :

Address line 2 :

Postal code :

Province :

City :

Home Telephone :

Emergency Number :

Home Language :

Cell Number :

Learners Cell No. :

Preferred language

Religion and Denomination, if applicable :

Name of Previous School :

Address of Previous School :

Telephone No. :

Code :

Province :

Country :

Medical Aid Name :

Medical Aid Main Member :

Doctor's Address :

Medical Aid No. :

Doctor's Name. :

Doctor's Telephone No. :

Has the applicant been vaccinated since infancy?

Yes

Please Give Details

State all infectious diseases that applicant has had :

Has the applicant have any physical disabilities and/or allergies ?

Yes

Please Give Details

If the applicant is currently suffering from any chronic disease or medical condition which needs monitoring, please give details :

Counselling Requirements :

Number of Siblings at Weston :

Position in the Family :

Please Supply Names of Siblings at Weston	Please Supply Names of Any Relatives Who Attended Weston

Name :

Grade :

Name :

Relationship :

Years Attended :

Name :

Grade :

Name :

Relationship :

Years Attended :

Name :

Grade :

Name :

Relationship :

Years Attended :

Please Indicate if you have any preference for a sport house

None

Parker

Smythe

Charlton

Paterson

Shorten

The School reserves the right to allocate learners to Sports Houses to ensure a fair distribution of age groups

May the applicant participate in recreational games on Sundays ?

Yes

Particulars of Sporting Ability/Achievements :

Title :

Initials :

Surname :

First Name :

Gender :

Female

Male

Home Language :

Account Payer :

Yes

Identification or Passport No :

Marital Status :

Married

Divorced

Widowed

Unmarried

Residential Street Address :

City/Surburb :

Code :

Postal Address :

City/Surburb :

Code :

Home Telephone :

Work Telephone :

Cell No. :

Email :

Occupation :

Employer :

Relationship to Learner :

Title :

Initials :

Surname :

First Name :

Gender :

Female

Male

Home Language :

Identification or Passport No :

Marital Status :

Married

Divorced

Widowed

Unmarried

Residential Street Address :

City/Surburb :

Code :

Postal Address :

City/Surburb :

Code :

Home Telephone :

Work Telephone :

Cell No. :

Email :

Occupation :

Employer :

Relationship to Learner :

Title :

Initials :

Surname :

First Name :

Gender :

Female

Male

Home Language :

Occupation :

Identification or Passport No :

Marital Status :

Married

Divorced

Widowed

Unmarried

Residential Street Address :

City/Surburb :

Code :

Postal Address :

City/Surburb :

Code :

Home Telephone :

Work Telephone :

Cell No. :

Email :

Employer :

Employer's Address :

Employer's Tel number :

Employer's Email :

To whom should correspondence be addressed : (Please tick one)

Primary Caregiver

Primary Caregiver’s Spouse/partner

Account Payee

Next-of-kin

I/We, the undersigned, declare that the information given on this Application for Admission is true and without error. I/We understand that this application will be rejected if it is incomplete or inaccurate in any way. I/we accept the conditions of admission as set out in the School Prospectus and in any other relevant school or Departmental rules or regulations.

SIGNATURE OF PRIMARY CAREGIVER

PRINT NAME AND SURNAME

DATE

SIGNATURE OF PRIMARY CAREGIVER’S SPOUSE OR PARTNER

PRINT NAME AND SURNAME

DATE

SIGNATURE OF PRIMARY CAREGIVER’S SPOUSE OR PARTNER

PRINT NAME AND SURNAME

DATE

Please Upload ID Photograph

Grade Applied For :

Highest Grade Passed :

Year Which This Grade Was Passed :

Present Grade :

Surname :

Initials :

First names :

Other Names :

Nickname :

Date of Birth :

Place of Birth :

Gender

Female

Male

Country of Residence :

If South African Indicate Province :

Citizenship :

ID number :

Street address :

Address line 2 :

Postal code :

Province :

City :

Home Telephone :

Emergency Number :

Home Language :

Cell Number :

Learners Cell No. :

Preferred language

Religion and Denomination, if applicable :

Name of Previous School :

Address of Previous School :

Telephone No. :

Code :

Province :

Country :

Medical Aid Name :

Medical Aid Main Member :

Doctor's Address :

Medical Aid No. :

Doctor's Name. :

Doctor's Telephone No. :

Has the applicant been vaccinated since infancy?

Yes

Please Give Details

State all infectious diseases that applicant has had :

Has the applicant have any physical disabilities and/or allergies ?

Yes

Please Give Details

If the applicant is currently suffering from any chronic disease or medical condition which needs monitoring, please give details :

Counselling Requirements :

Number of Siblings at Weston :

Position in the Family :

Please Supply Names of Siblings at Weston	Please Supply Names of Any Relatives Who Attended Weston

Name :

Grade :

Name :

Relationship :

Years Attended :

Name :

Grade :

Name :

Relationship :

Years Attended :

Name :

Grade :

Name :

Relationship :

Years Attended :

Please Indicate if you have any preference for a sport house

None

Parker

Smythe

Charlton

Paterson

Shorten

The School reserves the right to allocate learners to Sports Houses to ensure a fair distribution of age groups

May the applicant participate in recreational games on Sundays ?

Yes

Particulars of Sporting Ability/Achievements :

Title :

Initials :

Surname :

First Name :

Gender :

Female

Male

Home Language :

Account Payer :

Yes

Identification or Passport No :

Marital Status :

Married

Divorced

Widowed

Unmarried

Residential Street Address :

City/Surburb :

Code :

Postal Address :

City/Surburb :

Code :

Home Telephone :

Work Telephone :

Cell No. :

Email :

Occupation :

Employer :

Relationship to Learner :

Title :

Initials :

Surname :

First Name :

Gender :

Female

Male

Home Language :

Identification or Passport No :

Marital Status :

Married

Divorced

Widowed

Unmarried

Residential Street Address :

City/Surburb :

Code :

Postal Address :

City/Surburb :

Code :

Home Telephone :

Work Telephone :

Cell No. :

Email :

Occupation :

Employer :

Relationship to Learner :

Title :

Initials :

Surname :

First Name :

Gender :

Female

Male

Home Language :

Occupation :

Identification or Passport No :

Marital Status :

Married

Divorced

Widowed

Unmarried

Residential Street Address :

City/Surburb :

Code :

Postal Address :

City/Surburb :

Code :

Home Telephone :

Work Telephone :

Cell No. :

Email :

Employer :

Employer's Address :

Employer's Tel number :

Employer's Email :

To whom should correspondence be addressed : (Please tick one)

Primary Caregiver

Primary Caregiver’s Spouse/partner

Account Payee

Next-of-kin

SIGNATURE OF PRIMARY CAREGIVER

PRINT NAME AND SURNAME

DATE

SIGNATURE OF PRIMARY CAREGIVER’S SPOUSE OR PARTNER

PRINT NAME AND SURNAME

DATE

SIGNATURE OF PRIMARY CAREGIVER’S SPOUSE OR PARTNER

PRINT NAME AND SURNAME

DATE

T : + 27 (33) 263 1328

E : contact@weston.co.za

Weston Agricultural College

Registration

APPLICATION FORM

APPLICATION FORM
PARTICULARS OF LEARNER BEING ENROLLED

ADDRESS

PREVIOUS SCHOOL INFORMATION

MARKETING

APPLICANT'S MEDICAL INFORMATION

SIBLINGS

SPORT

PRIMARY CAREGIVER’S SPOUSE OR PARTNER’S INFORMATION

NEXT-OF-KIN
(This person will be contacted in case of emergencies, illness or other injuries should parent/guardian not be available)

ACCOUNT PAYEE
(The Person Responsible for Payment of the Applicant’s Tuition and Boarding Fees)

CORRESPONDENCE

APPLICATION FORM
PARTICULARS OF LEARNER BEING ENROLLED

ADDRESS

PREVIOUS SCHOOL INFORMATION

MARKETING

APPLICANT'S MEDICAL INFORMATION

SIBLINGS

SPORT

PRIMARY CAREGIVER’S SPOUSE OR PARTNER’S INFORMATION

NEXT-OF-KIN
(This person will be contacted in case of emergencies, illness or other injuries should parent/guardian not be available)

ACCOUNT PAYEE
(The Person Responsible for Payment of the Applicant’s Tuition and Boarding Fees)

CORRESPONDENCE

Download Application Form

Address

Keep in touch

Contact

Registration

APPLICATION FORMPARTICULARS OF LEARNER BEING ENROLLED

ADDRESS

PREVIOUS SCHOOL INFORMATION

MARKETING

APPLICANT'S MEDICAL INFORMATION

SIBLINGS

SPORT

PRIMARY CAREGIVER’S SPOUSE OR PARTNER’S INFORMATION

NEXT-OF-KIN(This person will be contacted in case of emergencies, illness or other injuries should parent/guardian not be available)

ACCOUNT PAYEE(The Person Responsible for Payment of the Applicant’s Tuition and Boarding Fees)

CORRESPONDENCE

APPLICATION FORMPARTICULARS OF LEARNER BEING ENROLLED

ADDRESS

PREVIOUS SCHOOL INFORMATION

MARKETING

APPLICANT'S MEDICAL INFORMATION

SIBLINGS

SPORT

PRIMARY CAREGIVER’S SPOUSE OR PARTNER’S INFORMATION

NEXT-OF-KIN(This person will be contacted in case of emergencies, illness or other injuries should parent/guardian not be available)

ACCOUNT PAYEE(The Person Responsible for Payment of the Applicant’s Tuition and Boarding Fees)

CORRESPONDENCE

Download Application Form

Address

Keep in touch

Contact

APPLICATION FORM
PARTICULARS OF LEARNER BEING ENROLLED

NEXT-OF-KIN
(This person will be contacted in case of emergencies, illness or other injuries should parent/guardian not be available)

ACCOUNT PAYEE
(The Person Responsible for Payment of the Applicant’s Tuition and Boarding Fees)

APPLICATION FORM
PARTICULARS OF LEARNER BEING ENROLLED

NEXT-OF-KIN
(This person will be contacted in case of emergencies, illness or other injuries should parent/guardian not be available)

ACCOUNT PAYEE
(The Person Responsible for Payment of the Applicant’s Tuition and Boarding Fees)