APPLICATIONS FOR ACADEMIC ADMISSIONS TO STUDIES

1 VANDERBIJLPARK CAMPUS ANDRIES POTGIETER BOULEVARD PRIVATE BAG X012 VANDERBIJLPARK1900 CONTACT USCALL CENTRE: 0861 861 888 FOR ACADEMIC ADMISSIONS TO STUDIES (NEW NATIONAL STUDENTS)Please note: To avoid disappointment, prospective students are urged to apply as early as possi-ble before the closing date. Make sure that VUT offers the course you are interested in (see overleaf) and that you adhere to theadmission requirements. Initial selection will be based on final Grade 11 or any Grade 12 results (final, mid-year and/or 3rdquarter).HOW TO the application form in full and answer all in plain block letters in the squares and use a black only the appropriate answer with an X in the squares where options are FOLLOWING MUST BE SUBMITTED WITH YOUR copy of South African identity copy of final Grade 11 or any Grade 12 Fee of R100 (non-refundable).

2 Application forms without proof of payment will not be accepted. NB: In case of APPLICATIONS submit-ted by mail,payments will only be accepted by bank deposit (ABSA Bank - account no.: 530 861 945; branchcode 632005; reference: your identity number), postal order or bank guaranteed cheque made outto the Vaal University of Technology. No Cash Should accompany your application form. Send completed form with the above-mentioned to the campus of your STATUS - SELF-CHECK:Go to the VUT website: and click on study at VUT tab. Select the self-check box and follow the easy DATE FOR APPLICATIONS .

3 30 SEPTEMBERFOR CONTACT DETAILS OF OTHER VUT CAMPUSES, SEE OVERLEAFCOURSES OFFERED AT VUT CAMPUSESVANDERBIJLPARK CAMPUSFACULTY OF APPLIED AND COMPUTER SCIENCESA nalytical Chemistry (DI1500)Biomedical Technology (DI0900)Biotechnology (DI1510)Non-Destructive Testing (DI1520)Information Technology (IT) (DI0600)Bachelor of Nursing (809001)FACULTY OF HUMAN SCIENCESF ashion (DI1000)Photography (DI0320)Graphic Design (D10310)Fine Art (D10300)Hospitality Management (DI1010)Public Relations Management (DI0500)Tourism Management (DI2200)Eco-tourism Management (204800)Legal Assistance (212801)Labour Law (212800)Safety Management (DI0420)Policing (DI2100) (SP & FET Teaching)(BD0700)Post Graduate Degree inHigher Education (PGDHE)(PGDHE)FACULTY OF MANAGEMENT SCIENCESCost and Management Accounting (DI0430)Internal Auditing (DI0460)Financial Information Systems (DI0440)Human Resources Management (DI0450)Marketing (DI0480)Retail Business Management (DI0490)

4 Sport Management (DI1900)Logistics (DI0470)FACULTY OF ENGINEERING AND TECHNOLOGYC hemical Engineering (DI0800)Civil Engineering (DI0810)Industrial Engineering (DI0830)Mechanical Engineering (DI0840)Metallurgical Engineering (DI0850)Engineering: Computer Systems (DI0822)Electrical Engineering Electronic Engineering(DI0823) Power Engineering(DI0824) Process Control(DI0825)OTHER VUT CAMPUSESTEAR OFF AND KEEP THIS PAGEDAVEYTON The Campus PrincipalPrivate Bag X025 Tel: 011 929 7400 Physical address:Brazil StreetDaveyton 1501 COURSESI nformation Technology (IT)Tourism ManagementMarketingInternal AuditingCost and Management AccountingSECUNDAThe Campus PrincipalPrivate Bag X025 Tel: 017 631 1990 / 1971 Physical address:Carl Bosch StreetSecunda2302 COURSESS afety ManagementChemical EngineeringElectrical Engineering Power Engineering Process Instrumentation Information EngineeringCost and Management AccountingUPINGTONThe Campus PrincipalPO Box 2468 Tel: 054 332 3304 Physical address.

5 Nelson Mandela Drive (Le Roux Street)Upington8800 COURSESA gricultural ManagementInternal AuditingCost and Management AccountingMarketingTourism ManagementHuman Resources ManagementIf yes, please give detailsPART BNATED DETAILSS econdary pupil (Grade 12)University studentUniversity of Technology studentFET / TVET College Labour force (employed)Population group141234 WhiteAsianColouredBlack15 PART CSCHOOL PARTICULARS: OTHER ACTIVITIESC itizenshipSouth AfricaName of other Country:10008010305070916 How were you occupied for the greater part of the last semester/year?

6 17 Have you ever been registered with a Higher Educational Institution?Yes*No*If Yes, include the ACADEMIC Record / Transcript from the Institution attendedOtherYear(s)Qualification / Course(s)Transcript from the Institution required18If registered as a student, or attempt tertiary education, give name of Institution19 Yes*NoWill you apply for subject exemptions?20 Date of Matriculation / Senior Certificate (Grade 12)MYEAR21 Examination number*If Yes, please submit your application for exemptions upon receipt of acceptance of Senior CertificateForeigners ExemptionImmigrants ExemptionOther Senior CertificateFET / TVET College08070605 Admission to BachelorsAdmission to CertificateAdmission to DiplomaBCDM atric aggregate*23*Average marks achieved24 Name of school and town/city where your school is situatedName of schoolTown/cityExamining Authority GautengPlease attach CERTIFIED COPIES of the 12 or equivalent Grade 12 report ( June examination)

7 Of conduct (if previously enrolled at another tertiaryinstitution) of results (if previously enrolled at another tertiaryinstitution) other formal qualifications you of address (not compulsory) : A Grade 12 report ( June examination or theGrade 12 advice of results only grants CONDITIONAL admission. Final admission will be granted only onreceipt of a certified copy of your Senior Certificateat Student Administration (CW Building); if all theadmission requirements of the University are met;and there is space of all post-secondary study25 InstitutionDiploma/DegreeSubjects passedYear2627 Hearing impairmentSpina BifidaHead InjuryCerebral PalsyQuadriplegicPART DGENERAL INFORMATIONDo you have a disability?)

8 Please tick correct circleYes:No:Yes:No:Do you suffer from poor health?28aIf yes, please specify:Yes:No:Are you on chronic medication?28bIf yes, please specify:Tick the relevant circles Physical DisabilityLearning DisabilityMobilityVisual or partial impairmentParaplegicADD / ADHDD yslexiaOther (Please specify)Epilepsy28cRegarding your illness/disability what kind of assistance will you require to make your ACADEMIC experience workable?Funding is available for all disabled applicants whose APPLICATIONS for admission is addressCell CodePostal CodePostal CodePostal Code313233 Cell (give abbreviation)MrMsDrProfRevThe (give abbreviation)NameAddressAddressNameTitle Street Name & NumberSuburbTownProvinceAccounts**Person that will be responsible for the All the sections provided for addresses (30-33)

9 Must be and address of parent / guardian/ relative not staying with you**In case of an emergency contact detailsResidential address29 Offering typeVanderbijlpark campusEkurhuleni campus(No residence accommodation)Upington campus(No residence accommodation)Secunda campus(No residence accommodation)0001000200140015 Full-time study (day classes)Full-time study (day classes)Full-time study (day classes)Full-time study (day classes)Part-time study (evening classes)Part-time study (evening classes)Part-time study (evening classes)Part-time study (evening classes)VFVPEPEFUFUPHPHFPART ESPORTS & HOBBIESPART FDECLARATION35 FOR USE BY UNIVERSITY ( ACADEMIC FACULTY) ONLY1.

10 I to comply with the rules and regulation of the Vaal University of Technology, should my application be successful, to inform the University immediately, in writing, if I change my address, to acquaint myself, each year/semester with all the rules and general regulations that relate to the programme for which I am I/We hereby absolve the Vaal University of Technology, its staff, employees, representatives and/or agents from any claims which I/the student mayacquire as a result of any injuries which I/the student may receive and/or damages which I/the student may suffer as a result of any happening,incident, accident, injury, illness or death, however it may have resulted.