Reapply-Hostel – Ligbron

Alternative contact and Medical information / Alternatiewe kontak en Mediese informasie

Name and Surname (not parent)

Naam en Van (nie ouer nie)

Relationship

Verwantskap

Contact number

Kontak nommer

Do you have medical aid

Het U 'n mediese fonds

Yes

Medical aid name

Naam van mediese fonds

Medical aid number

Lidnommer

Principle member

Naam van hooflid

Doctor's name

Naam van Dokter

Doctor's number

Nommer van Dokter

Does the learner have any medical conditions

Het die leerling enige mediese toestande

Yes / Ja

No / Nee

List any medical conditions (include along with application supporting documents)

Lys enige mediese toestande (sluit saam met aansoekdokumente in)

Upload supporting documents here / Laai ondersteunende dokumente hier op (optional / opsioneel)

Choose files to upload here / Kies dokumente om op te laai hier

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Is the learner on any medication

Is die leerling op medikasie

Yes / Ja

No / Nee

List learner medication the school needs to be aware of

lys enige medikasie waarvan die skool bewus moet wees

Special problems requiring attention/counseling

Spesiale probleme wat aandag/berading nodig het

Yes / Ja

No / Nee

List any special problems requiring attention/counseling (optional / opsioneel)

Lys enige spesiale probleme wat aandag/berading nodig het

Person accountable for hostel fees

Persoon verantwoordelik vir koshuisgeld

Father/Vader

Mother/Moeder

Sponsor/Borg

Title

Titel

Initials

Voorletters

Surname - Sponsor

Van

Full names - Sponsor

Volle name

Nickname - Sponsor

Noemnaam

ID - Sponsor

Home language - Sponsor

Huistaal

Home number - Sponsor

Huistekefoon

Cell number - Sponsor

Sel nr.

E-mail address - Sponsor

E-pos

Relationship to Learner

Verhouding tot leerder

Full Home address - Sponsor eg. 1 Voortrekker Street, Ermelo, 2350

Volle Woonadres bv. 1 Voortrekker Straat, Ermelo, 2350

Postal address - Sponsor

Posadres

Payment schedule / Betalingskedule

Full payment with registration or first school day. / Volle betaling met registrasie of eerste skooldag.

Quarterly / Kwartaalliks (4 Payments / Betalings)

Per Month / Per Maand (Feb - Nov) 10 Months

Agreement / Ooreenkoms

Agreement between LIGBRON ACADEMY OF TECHNOLOGY and the parent/guardian(Named below) with regard to the payment of hostel fees.
Ooreenkoms tussen LIGBRON AKADEMIE VIR TEGNOLOGIE en (Naam van ouer/voog hieronder) t.o.v. betaling van koshuisgelde.

1. Should a court determine that another person is liable for the hostel fees, it still remains the responsibility of the parents/guardians who qualify as parents in terms of the definition “parent” as contained in die SA Schools Act, to ensure that the hostel fees are paid.
1. Indien ‘n hof bepaal het dat ‘n ander persoon die koshuisgelde moet betaal, bly dit steeds die verantwoordelikheid van almal wat as ouers van die ingeskrewe leerder kwalifiseer, ooreenkomstig die definisie (ouers) in die SA Skolewet, om die koshuisgelde te betaal.
2. Should payments of hostel fees be in arrears, I shall be accountable for the payment of fees that may arise in the effort to collect the fees on an attorney and client scale.
2. Indien ek agterstallig is met betaling van koshuisgelde, sal ek aanspreeklik wees vir betaling van die kostes aangegaan om dit in te vorder op ‘n prokureur en kliënteskaal.
3. I choose the following address as my domicillium citandi et executandi for delivery or serving of any notices or pleadings.
Residential address (Not a postal address):
3. Ek kies hierdie onderstaande adres as my domicillium citandi et executandi vir aflewering of betekening van kennisgewings of pleitstukke: Woonadres (Nie ‘n posbus adres nie):

4. I/We the parents/guardian undertake to honour the agreement as set out above.
4. Ek/Ons die ouers/voog onderneem om my/ons te hou by die ooreenkoms soos hierbo uiteengesit.

Signature of parent / guardian / sponsor

Handtekening van ouer / voog / borg

I/We the parents/guardian undertake to honour the agreement as set out above, if not, Ligbron Academy may take the necessary steps.
I agree that my typed name below will be as valid as a handwritten signature to the extent allowed by local law.
I confirm that upon submission of the above-mentioned form, albeit per e-mail or by hand, that I consider myself bound by the terms and conditions as set out above and that I understand the contents thereof.
I confirm that the absence of my signature does not mean that the document is not applicable to me.

Ek / ons die ouers / voog onderneem om die ooreenkoms soos hierbo uiteengesit na te kom, indien nie, mag Ligbron Akademie die nodige stappe doen.
Ek stem saam dat my getikte naam hieronder net so geldig is soos 'n handgeskrewe handtekening in die mate wat die plaaslike wetgewing dit toelaat.
Ek bevestig dat by indiening van gemelde vorm, hetsy by wyse van epos of per hand, ek myself gebonde ag aan die terme en voorwaardes hierbo uiteengesit en dat ek dit verstaan.
Ek bevestig dat die nie aanbring van my handtekening nie beteken dat die dokument geldig is op my nie.

Date / Datum

HOSTEL
RE-APPLICATION FORM

KOSHUIS HERAANSOEK

ENGLISH PRINTABLE version

AFRIKAANSE druk weergawe

HOSTELRE-APPLICATION FORM

KOSHUIS HERAANSOEK

ENGLISH PRINTABLE version

AFRIKAANSE druk weergawe

HOSTEL
RE-APPLICATION FORM