DURBAN HIGH SCHOOL

1 255 St Thomas Road DURBAN 4001 PO Box 50001 Musgrave 4062 Tel: 031-277 1500 Fax: 031-277 1555 Email: DURBAN HIGH SCHOOL APPLICATION FOR ADMISSION for 2019 Please Note: 1. The closing date for applications for 2019 is 30 June 2018. 2. All sections in the application form must be completed in full by the applicant s parents/guardians, signed and returned to the SCHOOL accompanied by the documentation listed below. Incomplete applications cannot be processed. 3. The physical address should be that of the parent or legal guardian.

2 If the guardian is not the biological parent, proof of legal guardianship (as recognised by SA law), including a commitment to pay SCHOOL fees, must accompany the application. The applicant must permanently reside at that address. 4. The enclosed confidential report is to be submitted to the applicant s current SCHOOL for completion and then submitted to DURBAN High SCHOOL . If not submitted timeously this could lead to delays in processing the application. 5. The submission of an application form is not a guarantee that the applicant has been awarded a place and should in no way be construed as an expectation of a place in the SCHOOL .

3 6. Please note that the medium of instruction at DURBAN High SCHOOL is ENGLISH. Learners are expected to study in English Home Language. 7. No faxed or emailed applications can be accepted. 8. Any falsely submitted information, including financials, will invalidate this application. PLEASE ATTACH THE FOLLOWING DOCUMENTATION TO YOUR APPLICATION form (all copies MUST be certified): Latest SCHOOL Report (ie, December 2017) Unabridged Birth Certificate (3 Copies) or application receipt +abridged birth certificate Original Colour Photograph - passport size (3 Prints) Recent Utility Bill (Water and/or Lights (Metro) account) or lease agreement Account Reference (eg, Clothing Store or Cell phone Account) with residential address Two (2) Months current Bank Statement for both parents/guardians Latest Salary Advice for both parents/guardians Death Certificate (if either parent is deceased)

4 Parents/Guardians ID for both parents/guardians CV if applying for Scholarship (the SCHOOL reserves the right not to award a Scholarship) Est. 1866 DURBAN HIGH SCHOOL APPLICATION FOR ADMISSION for 2019 YEAR OF ENTRY: GRADE OF ENTRY: BOARDER: TO START IN TERM: (state which term): PRESENT GRADE: DAY SCHOLAR: SECTION A LEARNERS DETAILS: Surname: .. First Names: .. Date of Birth (dd/mm/yyyy): .. ID No.. Home Language: .. Citizenship: .. (If not South African please attach a copy of residency and study permits) Learner s Residential Address.

5 Reason if address is different to Legal Parent/Guardian: .. Name of Present SCHOOL : .. SCHOOL Telephone: .. SCHOOL Fax No.. Has the learner ever repeated a Grade: .. If yes, which Grade? .. Reason for repeating of Grade: .. Are any family members DHS Old Boys or currently at DHS? Family Member s Name & Surname: .. Present Grade: .. Family Member s Date of Birth: .. Family Member s SCHOOL House: .. Any other link/connection with DHS : .. MEDICAL INFORMATION: Health Problems/Allergies: .. Medical Aid Name.

6 Medical Aid No.. Medical Aid Principal Member: .. ACADEMICS: Academics (please fill in the most recent marks) Mathematics (%): .. Physical Sciences (%) .. English (%): .. Aggregate (%) .. Academic Awards (prizes, certificates, medals, etc): .. LEARNERS EXTRA-MURAL INVOLVEMENT: Cultural and Community: SCHOOL Clubs or Societies: .. Out of SCHOOL Activities (scouts, dance, art lessons, etc): .. Music: Yes No Instrument: .. Choir: Yes No Leadership: Positions of Leadership/Responsibility Held.

7 Sport: Summer Sports Age Group Team Represented Position .. Winter Sports Age Group Team Represented Position .. Other Sport: .. Please note that all Grade 8-11 boys are required to play a minimum of two (2) sports during the year, one (1) summer sport and one (1) winter sport. SECTION B PARTICULARS OF THE PARENTS (if either parent is deceased, please attach a certified copy of the Death Certificate) Father s Details: Mother s Details: Marital Status Marital Status Married Divorced Single Widowed Married Divorced Single Widowed Title (Prof, Dr, Mr).

8 Title (Prof, Dr, Mrs, Ms): .. Surname: .. Surname: .. First Names: .. First Names: .. ID No.. ID No.. Contact Details: Contact Details: Postal Address: .. Postal Address: .. Code: .. Code: .. Physical Address (domicilium citandi et executandi): Physical Address (domicilium citandi et executandi): .. Code: .. Code: .. Home Telephone No: .. Home Telephone No: .. Cell No: .. Cell No: .. Email Address: .. Email Address: .. (Please print clearly) (Please print clearly) Occupation.

9 Occupation: .. Name of Employer/Business: .. Name of Employer/Business: .. Type of Business: .. Type of Business: .. Work Telephone: .. Work Telephone: .. Business Address: .. Business Address: .. Next of Kin Details (not wife): Next of Kin Details (not husband): Full Name: .. Full Name: .. Home Telephone: .. Home Telephone: .. Cell No: .. Cell No: .. If parents are separated/divorced, please indicate who the custodial parent is : Mother Father Who does the Learner live with: Mother Father Other.

10 Name/Address of Guardian, if applicable: .. SECTION C DECLARATION/UNDERTAKINGS BY APPLICANT and PARENTS/GUARDIANS 1. We have read and understood the statements and questions on this form . The information supplied by us, individually or together, is complete and true in every respect. If any of the supplied information is found to be incomplete, incorrect, untrue or misleading, the SCHOOL may cancel any offer of a place and refuse to accept any future application in respect of the same applicant. 2. We undertake to accept and abide by the code of conduct of the SCHOOL , and such rules and regulations as are put in place by the SCHOOL or Governing Body from time to time.