6464 APPLICATION FORM - Vuselela TVET College

1 VUS-06-0- 6464 -WIL/wil-15-00 2015-10-29 Page 1 of 4 APPLICATION form All fields must be completed before submitting the form1 AT WHICH CAMPUS DO YOU WANT TO STUDY? Jouberton Klerksdorp Matlosana Potchefstroom Taung TITLE Mr Ms Mrs Miss Pastor Father Doctor Minister Reverend Professor Honourable INITIALS SURNAME NAME/S DATE OF BIRTH PASSPORT NUMBER D D M M M Y Y Y Y GENDER MARITAL STATUS Male Female Single Married Divorced Widowed FOR OFFICE USE Approved Y N Waiting list Y N Student number

2 Date Staff member APPLICATION FOR YEAR OF STUDY ID NUMBER Tel: 018406 7800 Fax: 018 406 7810 PO Box 10, Klerksdorp, 2571 2 VUS-06-0- 6464 -WIL/wil-15-00 2015-10-29 Page 2 of 4 WHICH PROGRAMME ARE YOU APPLYING FOR? Please make sure that the programme you wish to study is offered at the campus of intended study REPORT 191 BUSINESS AND UTILITY STUDIES N4 N5 N6 N4 N5 N6 Business Management Human Resource Management Management Assistant Marketing Management Tourism REPORT 191 ENGINEERING STUDIES N1 N2 N3 N4 N5 N6 Civil Engineering Plumbing Carpentry & Roofwork Bricklaying & Plasting Mechanical Engineering Fitting & Maching Boilermaking Motors/Diesel

3 Electrical Engineering Other - specify NATIONAL CERTIFICATE (VOCATIONAL) L2 L3 L4 L2 L3 L4 Civil Engineering & Building Construction Drawing Office Practice Electrical Infrastructure Construction Engineering & Related Design Finance, Economics & Accounting IT & Computer Science Hospitality Office Administration IT & Computer Science Primary Agriculture 3 VUS-06-0- 6464 -WIL/wil-15-00 2015-10-29 Page 3 of 4 HOME LANGUAGE A Afrikaans B Siswati C Isindebele D Sepedi E English F Xitsonga G Tshivenda H Setswana I IsiXhosa J IsuZulu K Sesotho L South African Sign Language M Other CITIZENSHIP South Africa Mozambique Zimbabwe

4 Botswana Lesotho Other ETHNIC GROUP 1 White 2 Coloured 3 Indian 4 Black WHERE DID YOU HEAR ABOUT Vuselela TVET College ? Radio Website Brochure Open Day Facebook School Visit Church Advertisement Career Exhibition Other TVET College Student/Teacher At School HIGHEST GRADE PASSED IN SCHOOL MATRIC TYPE 1 Grade 12 without Endorsement 2 No Grade 12 3 Grade 12 with Endorsement CONTACT DETAILS Postal address Town/city Postal code Cell nr of student Alternative cell nr Relationship to student E-mail address of student

5 4 VUS-06-0- 6464 -WIL/wil-15-00 2015-10-29 Page 4 of 4 PLEASE READ THE FOLLOWING CAREFULLY BEFORE COMPLETING THIS form : 1. This form must be completed by all students applying to Vuselela TVET College for the first time. 2. This is just an APPLICATION form . It does not guarantee you registration for a programme. 3. You will be informed via a sms whether your APPLICATION was successful or not. 4. The APPLICATION form must be signed by the applicant and the legal guardian (if applicant is younger than 18 years).

6 5. It is in your own interest to ensure that this form is completed in full and that certified copies of all supporting documentation are enclosed. 6. Complete the form in black ink and use block letters. 7. A certified copy of your Identity Document must accompany this APPLICATION . 8. A certified copy of your highest qualification must be submitted with your APPLICATION . 9. Grade 12 learners must attach a certified copy of their Grade 11 final results and June or September Grade 12 results. 10.

7 Proof of residential address of parents/guardian or municipal account. THUS SIGNED AT ON THIS DAY OF 20 STUDENT PARENT/GUARDIAN