2023 Application for Undergraduate Admission

1 SURNAME:FIRST NAME:FOR OFFICE USECAMPUS ID:EMPL ID:2022 Application FOR UNDERGRADUATEADMISSION UCT is aware that the current crisis related to COVID-19 will impact the regular operational timelines. Given the fluid situation that prevails all dates contained in our publications and correspondence are subject to change. Apply online at Use this booklet only if you do not have access to the internet. If you are currently registered at UCT, and wish to transfer to another Undergraduate programme, you must consult the Faculty that you wish to transfer to. Undergraduate applications close on 31 August 2021. We do not accept late applications .

2 Complete this form using the information and codes found in the tables in the 2022 Directions for Undergraduate Applicants. Please complete this form in CAPITAL LETTERS in ink. Return this completed form by email to with the subject line 2022 Undergraduate Application Form or by post. As there may be delays with the post, we strongly encourage email submissions. DO NOT submit your Application fee with this form. Refer to the 2022 Directions for Undergraduate Applicants for instructions regarding Application fee APERSONAL DETAILSSECTION CPROGRAMMES OF STUDY FOR WHICH YOU ARE APPLYINGC hoiceAcademic plan code (Table A)1st Choice2nd ChoiceChoiceAcademic plan code 2 (Table A)1st ChoiceSB0012nd ChoiceSB001 Surname:First name/s:Preferred first name:Former surname:Surname onNational Senior Certificate (for NSC writers only):If you have applied to UCT before, enter your applicant/student number:Are you a South African citizen?

3 Are you a South African permanent resident?If you need assistance because of a disability, please specify the disability/ies (Table H) so we can plan to help you:Citizen Permanent ResidentCitizenPermanent ResidentCitizenPermanent ResidentIf you are a citizen or permanent resident in a country other than South Africa, please provide details here:Country (Table I): Citizenship status (please tick) Passport number (where available)Sex: (please tick one) Female: Male: Trans:Home language (Table H):Page 1 of 5 Only for Faculty of ScienceapplicantsSECTION BNATIONAL BENCHMARK TEST (NBT) NUMBERAll applicants to Undergraduate programmes (with the exception of the Faculty of Engineering & the Built Environment which does not have a NBT requirement) normally resident, or at school, in South Africa, and all Health Sciences applicants, wherever resident, must write the NBTs.

4 If you wish to be considered for a conditional offer by the Faculty of Health Sciences, you must write the NBTs by 31 August 2021. If you write the NBTs after 31 August, you will only be considered for an offer in early 2022 after your final examination results are received. The final date to write the NBTs for Admission to UCT is 2 October 2021. If you are required to write the NBTs, you must register for NBTs before submitting this form. Enter your 14-digit NBT registration number and, if you wrote before 2021, the year the NBTs were written. NBT results are only valid for two years prior to the year of Application ; so if you wrote the NBTs in 2019 or 2020, the results remain valid but you may choose to rewrite in 2021.

5 Year written:20YY2021 test date:DDMMNBT registration number:Title (Table H):Date of birth:DDMMYYYYSA identity number:Ye s NoYe s NoInclude a certified copy of your South African identity card or documentInclude a certified copy of your passportSECTION DYOUR CONTACT DETAILSPage 2 of 5 Home (street) address:Postal/zip code:Email address:Country tel code: Dialling code: Telephone number:SECTION EPARENT / GUARDIAN CONTACT DETAILSC ompulsory if you are under 18 (street) address: Country tel code: Cellular number: Country tel code: Dialling code: Telephone number: Postal/zip code:Title (Table H): Surname of parent/guardian:First names of parent/guardian:Email address:Identity/passport number of parent/guardian: Relationship to you: Relationship code (Table J):SECTION FFEE PAYER information If your Fee Payer is also your parent/guardian, and you completed Section E, you do not need to complete this section.

6 If not, this section is (street) address: Country tel code: Cellular number: Country tel code: Dialling code: Telephone number: Postal / zip code:Title (Table H): Surname of parent/guardian:First names of parent/guardian:Email address:Identity/passport number of parent/guardian: Relationship to you: Relationship code (Table J): Country tel code: Cellular number: Home (postal) address: (if different from Home (street) address)Postal/zip code:SECTION GREDRESS & DIVERSITY information : SA APPLICANTS ONLY3.

7 What is/was your mother s first language?4. What is or was the highest level of education of each of parents/guardians, and your grandparents (highest of all of them)? Please tick one box: (where applicable) University or Technikon degree .. University or Technikon certificate or diploma .. Technical College certificate, trade certificate or similar certificate .. Matric/Grade 12/Senior certificate .. Some formal schooling .. No formal schooling .. I do not know ..5. Does or did your family receive a child-support grant on your behalf? ..6. Does or did your family rely on a social pension from the State? ..This section applies to South African citizens and permanent residents only and is compulsory.

8 The University s redress and diversity policies apply to South African Undergraduate applicants whose parent/s was/were classified under apartheid as Black, Coloured, Chinese or Indian. Your responses to the following questions are used to calculate your redress category and disadvantage factor. The disadvantage factor will be used in the calculation of your Weighted Points Score. Refer to page 10 of the 2022 Undergraduate Prospectus for an explanation of the University s Admissions Under apartheid, my mother was classified as (please tick only one):2. Under apartheid, my father was classified as (please tick only one):Mother/Female Guardian Father/Male GuardianGrandparentsYe sNoI do not knowYe sNoI do not knowBlack Coloured Chinese IndianWhiteDo not knowI choose not to answer this question My mother did not live under apartheidBlack Coloured Chinese IndianWhiteDo not knowI choose not to answer this question My father did not live under apartheidSECTION H2021 SECONDARY SCHOOL-LEAVING EXAMINATION DETAILSFor Cambridge Assessment International Education applicants: Centre no.

9 : Candidate no.:Code(Table D)Level(Table E)School subjects to be written this year:Complete this section if you are writing a school-leaving examination in 2021. Supply only details of secondary schools located in South Africa. If you attend school outside of South Africa, omit secondary school address:Postal code: (Table H)Did you attend any other secondary school before enrolling at your present school?Ye sNoYYYYIf yes, in which year did you first enrol at your present school:If yes, please provide the code of your previous school:(Table B) Schoolname:School code:(Table B) (Table C)Examining authority: Page 3 of 5 Page 4 of 5 SECTION KFINANCIAL ASSISTANCESECTION ISECONDARY SCHOOL-LEAVING AND POST-SCHOOL INFORMATIONS chool address: Date written:DDMMYYYY Postal code.

10 Year Activity Code (Table F) Year Activity Code (Table F) YYYYYYYYYYYYYYYYC omplete this section if you have already left school. Supply only details of secondary schools located in South Africa. If you attended school outside of South Africa, omit secondary school details. Please enclose certified copies of your final results and certificate/s. (Table C) (Table B) DETAILS OF ACTIVITIES SINCE LEAVING SCHOOL OTHER THAN TERTIARY EDUCATIONIf you have left school and are not at a tertiary institution, you must complete this section.