registration panel - isilomosamazunguecd

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The Director
Registration Panel

Home
About us
Services
Gallery
The Director
Registration Panel

Name *

First

Last

Email *

Comment or Message

registration form

Cell Number: 073 392 3491

Office Contact Details

Landline: 031 921 1647

Email: info@isilomosamazunguecd.co.za

childs name *

First

Middle

Last

gender

does the child have a birth certificates?

if 'no' state a reason

descibe the reason if other

date of birth ( eg- year -month- day- age)

does the child have immunisation card?

id number child

please provide parents information below

race

are you SA citizen?

non citizen spacify

home address

city/ town

postal code

contact numbers *

First

Last

emergency contact number

name of contact person

home language

isizulu
english
afrikaans
other

is the child getting grant?

yes
no

type of grant

child support
foster child
care dependancy

o.v.c

yes
no

Parent/ gardian information

parent Name *

First

Last

title

marital status

single
married
widow

gender

home language

id number

race

relationship to the child

does the child resides with this parent?

are you the account payee?

yes
no

occupation if employed

employer

contact number *

First

Last

work number

This section is a signature of agreement that the above information is lawfully stated by me and I agree to comply with school's terms abd conditions

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