2018 Application Form - South West Gauteng TVET …

1 CALL CENTRE NUMBER: 086 176 8849 SWGC-ADM- Application form - 01 2015/09/11 Page 1 of 2 Address all correspondence to Private Bag X33, Tshiawelo, 1817 / Distance Education correspondence to Private Bag X7, Pinegowrie, 2123 Head Office Fax: 011 984 1262 E-mail: 1822A Molele Street Molapo Contact Centre Fax: 011 9451881 E-mail: Klip Valley /Union St Kliptown Dobsonville Campus Fax: (011) 988 9212 E-mail: 5604 Van Onselen Road Dobsonville GeorgeTabor Campus Fax: (011) 982 5543 E-mail: 1440 Mncube Drive Dube Molapo Campus Fax: (011) 984-0136 E-mail: 1822B Molele Street Molapo Roodepoort Campus Fax: (011) 763 5937 E-mail: 1 Webber Avenue Horizon Roodepoort West Campus Fax: (011) 766 4214 E-mail: 1 Lawson Street Roodepoort West Technisa Campus Fax: (011) 886 7997 E-mail Cnr Main & Huguenot Blairgowrie 2018 Application form (Please note that this is not a registration form , the registration forms will be made available to successful applicants) 2.

2 Personal Details 3. Contact Details Tel No (H) Tel No (W) Guardian Cell No (Mother) Cell No (Father) Cell No (Student) E-Mail(Self and/or parent) Fax No Cell No (Other Relatives) Preferred method of communication (please tick) e-mail Cell/Mobile Post Fax Physical Address of Student Postal Address: (Company / Parent / Guardian) Postal Code Postal Code PROGRAMME: (refer to No. 4 below) Trade (applicable to Engineering Studies only) PREFFERED CAMPUS: (refer to No. 6 below) Full-time Part-time Surname Initials Title Mr Ms Mrs Full Name(s) SAME ORDER AS IN ID BOOK (DO NOT INCLUDE SURNAME) ID (Attached certified copy) Y Y M M D D Gender Male Female Ethic Group 1 African 2 Coloured 3 Indian 4 White 5 Other Mother Tongue ENGlish AFRikaans isiXHOSA SETswana isiSWATI XITsonga TSHivenda SEPedi SESotho isiZULU isiNDEBELE Unknown/Other Marital Status 1 Single 2 Married 3 Divorced 4 Other Highest qualification/Grade passed (Attached certified copies)

3 RSA Citizen Y N Other Country CURRENT ACTIVITY This TVET College Other College School (Grade) Working Unemployed Name of Parent / Guardian Relationship to student CALL CENTRE NUMBER: 086 176 8849 SWGC-ADM- Application form - 01 2015/09/11 Page 2 of 2 Address all correspondence to Private Bag X33, Tshiawelo, 1817 / Distance Education correspondence to Private Bag X7, Pinegowrie, 2123 Head Office Fax: 011 984 1262 E-mail: 1822A Molele Street Molapo Contact Centre Fax: 011 9451881 E-mail: Klip Valley /Union St Kliptown Dobsonville Campus Fax: (011) 988 9212 E-mail: 5604 Van Onselen Road Dobsonville GeorgeTabor Campus Fax: (011) 982 5543 E-mail: 1440 Mncube Drive Dube Molapo Campus Fax: (011) 984-0136 E-mail: 1822B Molele Street Molapo Roodepoort Campus Fax: (011) 763 5937 E-mail: 1 Webber Avenue Horizon Roodepoort West Campus Fax: (011) 766 4214 E-mail: 1 Lawson Street Roodepoort West Technisa Campus Fax: (011) 886 7997 E-mail Cnr Main & Huguenot Blairgowrie 4.

4 Programmes REPORT 191 (NATED) Business Studies: N4 N6 Engineering Studies: N1 N6 Utility Studies: N4 N6 programmes Business Management Marketing Management Civil Engineering Electrical Engineering Introductory Clothing Construction Clothing Production Human Resource Management Public Management Mechanical Engineering Water and Waste-Water Treatment Practice N1-N3 Educare Hospitality and Catering Services Management Assistant Financial Management Popular Music: (Composition, Studio Work and Performance National Certificate (Vocational) [NC (V)] Business Studies NC (V) Level 2 - 4 Engineering Studies NC (V) Level 2 - 4 Utility Studies NC (V) Level 2 - 4 programmes Finance, Economics & Accounting Management Civil Engineering & Building Construction Engineering and Related Design Education and Development Hospitality Primary Health Primary Agriculture Marketing Office Administration Electrical Infrastructure Construction Information Technology and Computer Science Safety in Society Tourism Transport and Logistics 5.)

5 Disability Disabilities (Please attach the medical certificate from doctor) Blindness Deafness Deaf-blindness Partial sightedness/ Low vision Hard of hearing None Cerebral Palsy Autistics Spectrum disorders Psychiatric disorder Epilepsy Physical Disability Mild to moderate intellectual disability Specific learning disability Behavioural/ conduct disorder Attention to difficult disorders 6. Campuses Campuses Dobsonville Campus (Business Studies only) 5604 Van Onselen Road Dobsonville George Tabor (Utility Studies only) 1440 Mncube Drive Dube Village Molapo Campus (Engineering Studies only) 1822 A Molele Street C/o Koma Road Molapo, Soweto Roodepoort Campus (Business and Utility Studies) No.

6 3 Webber Street Horizon View Roodepoort Roodepoort West Campus (Engineering Studies only) No. 1 Hinda Road C/o Hinda & Lawson Street Roodepoort Technisa Campus (Business Studies [NC (V)] and Distance Learning) Cnr. Huguenot Avenue & Main Street, Bordeaux, Randburg 7 NSFAS BURSARY REQUIRED? Yes No 8 DISTANCE LEARNING Please refer to the college website for Distance Application form : 9. DECLARATION I hereby declare that the information above is accurate and correct and that should I, the applicant, be accepted as a student, I will unconditionally adhere to the rules and regulations of this College.

7 I take note that I will occupy a high premium space, which could easily have been allocated to another deserving applicant. I undertake to utilize this space fully. I commit to stay in the programme for its total duration. Signed: Parent / Guardian (Where Applicable) Signed: Applicant .. Name of processing Officer Date: Signature of processing Officer In case the applicant is underage, the parent s/guardian s agreement will be binding.. Date: .. Date.