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Application for Admission - Full Time
Do you require accommodation?Benodig u akkommodasie?
Title (eg. Mr/Ms):Titel (bv. Mnr/Mej):
Gender:Geslag
Surname:Van:
First names in full:Volle voorname:
Name:Noemnaam:
ID Number:ID-nommer:
NationalityNasionaliteit
Home LanguageHuistaal
Ethnic GroupEtniese Groep
Study VisaFor international Students
Cellphone number:Selfoonnommer:
Home Number:Huisnommer:
Postal address:Posadres:
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Postal code:Poskode:
Residential address:Woonadres:
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Postal code:Poskode:
Preferred language of study material:Taalvoorkeur vir studiemateriaal:
Marital StatusHuwelikstatus
DisibilityGestremdheid
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FIELD OF STUDY (TICK APPLICABLE) / STUDIERIGTING (MERK TOEPASLIKE)
Potchefstroom Academy Qualifications:Potchefstroom Akademie Kwalifikasies:
SAAHST Qualifications:SAAHST Kwalifikasies:
DETAILS REGARDING SCHOOL EDUCATION / INLIGTING AANGAANDE SKOOLOPLEIDING
Name of school:Naam van skool:
Town/city in which school is situated:/ Dorp/stad waar skool geleë is:
Highest qualificationHoogste kwalifikasie:
Please list your subjects:Lys asb jou vakke:
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INFORMATION OF PARENT/GUARDIAN / INLIGTING VAN OUER/VOOG
Title (eg. Mr/Ms):Titel (bv. Mnr/Mej):
Relationship:Verwantskap:
First names in full:Volle voorname:
Surname:Van:
Home telephone number:Huis tellefoonnommer:
Work telephone number:Werk telefoonnommer:
Cellphone number:Werk telefoonnommer:
Fax number:Faksnommer:
Postal address:Posadres:
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Postal code:Poskode:
Residential address:Woonadres:
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Postal code:Poskode
Employer:Werkgewer:
Occupation or position held:Beroep of pos beklee:
Work address:Werkadres:
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E-mail address:E-posadres:
SUPPORTING DOCUMENTS / STAWENDE DOKUMENTE
ID document:ID dokument:
Upload
Most recent school report:Mees onlangse skool verslag:
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