2018 Information Form

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Rosebank primary School 2018 Information form SCHOOL DETAILS: Gauteng registration (EMIS) number: 700151456 Type of School: Sectional 21 DATE OF APPLICATION: _________________________ GRADE APPLYING FOR: ______________ DETAILS OF LEARNER: Gender (Boy or Girl): __________________________ Date of Birth: ______________________________ Surname: ___________________________________ First Names: _______________________________ Identity Number: _____________________________ Nationality: ________________________________ Home Language: _____________________________ Passport Number: ___________________________ Name of Previous School: ______________________ Tel No of Previous School:_____________________ Address of Previous School: ____________________ Fax No of Previous School: ____________________ First Additional Language Choice (Grade 4 7 only): ___________________________ (Afrikaans or Zulu) SIBLING Information : (cousins are not siblings) Name of Brother/Sister at Rosebank: _____________________ Grade: ______ Sports House: __________________ ADDITIONAL Information : Deceased parent: Mother: _________ Father: _________ Both: __________ With whom does your child reside (parents, mother, father, grandparent, guardian)?

Rosebank Primary School 2018 Information Form SCHOOL DETAILS: Gauteng registration (EMIS) number: 700151456 Type of School: Sectional 21 DATE OF APPLICATION: _____ GRADE APPLYING FOR: _____

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