FURTHER EDUCATION AND TRAINING PHASE (GRADE 10 TO …

1 2019 FURTHER EDUCATION AND TRAINING PHASE ( grade 10 TO 12) REGISTRATION FORMR eturn form to numberEmail1. LearnerTake note: Only one learner per formSurnameFull namesTitleInitialsID number(required)Type of IDSA IDPassportOtherCopy of ID/Birth certificate attached (compulsory)YesNoDate of birthThe registration process:Language of communicationMMYDD//YYYP hysical addressCity/TownPostal codeStreetSuburbProvinceCountry(Decimal degree format) Coordinates (optional)Please note that an online registration process for this and other options is available on our website ( ).Application is processedLesson material is orderedComplete and submit the registration form and attach the required documentsDeposit is paidOn approval, quote is sent to account holderStudent number used as reference13452 Impaq to completeImpaq to completeImpaq to completeAfrikaansEnglish(English by default, if no option is selected)*Assessments will only be made available in an electronic format via Impaq s online portal, with the exception of Engineering Graphics and Design (EGD)

2 And Geography you want to register for an individual subject , or fewer than the required number of subjects, please complete the individual subject registration OtherPage 1 of 11 Have you registered with Impaq before?Student numberNoYesManual registrations: What we offer on this form Assessment and support services 123456 Learner materials (Printed)Facilitator guides (Printed)Online tutoring and practiceCapture marks, generate reports & monitor a learner s progressGuided learning platformSelect one method of delivery:2. Delivery method Printed material format City/TownStreetSuburbProvinceCountryPhys ical addressCourierCollect from distributorA non-refundable delivery fee is included in the deposit: R290 in South Africa and a R1000 (VAT exempt) in Namibia.

3 Impaq does not deliver to any other countries. Collection in person or via an appointed courier can be done from our distributor in Irene, Centurion. Clients will be contacted once the parcel is available for collection. RSAN amibiaBuilding/Complex/FarmCourierAPosta l codeLatitudeLongitude(Decimal degree format).GPS Coordinates (optional)orRequired when registering with an Impaq network tutor, if collection not from distributorBSame as physical academic communication and notices will be sent to this email numberSMS communication will be sent to this numberEmail3. Account holder Person responsible for paymentAll financial correspondence will be sent to this email numberCell numberEmailSurnameFull namesTitleInitialsID number(required)SurnameFull namesTitleInitialsID number4.

4 Legal guardianSame person as account holder?Yes You do not need to complete this Physical addressCity/TownStreetSuburbCountryCity/ TownPostal codeStreet/ PO BoxSuburbProvinceCountryPostal address Same as physical addressPostal codeProvincePhysical addressCity/TownStreetSuburbCountryCity/ TownPostal codeStreet/ PO BoxSuburbProvinceCountryPostal address Same as physical addressPostal codeProvinceType of IDSA IDPassportOtherSpecify OtherPLEASE NOTE: A copy of the account holder s ID must be of IDSA IDPassportOtherSpecify OtherPage 2 of 115. Tutor linkingTake note: Impaq does not contract with tutors nameNoDo you want to link an Impaq network tutor to this application?

5 Tutor codeI hereby authorise system access to the above-mentioned tutor centre to support me in administering/managing my child s assessments. I understand that granting this third party access to my child s profile is in support of my obligations as a home EDUCATION parent and that I remain accountable for my child s :MMYDD//YYYYesSignature: Account holder/Guardian6. Package selection: FET PHASE grade 10R14 497 Select content optionCost*Assessments will only be made available in an electronic format via Impaq s online portal, with the exception of Engineering Graphics and Design (EGD) and Geography materials (printed)Facilitator materials (printed)Page 3 of 11 Select two languages(at least one home language)

6 2 English Home LanguageEnglish First Additional LanguageAfrikaans HuistaalAfrikaans Eerste Addisionele TaalororandCompulsory subjects3 Select your Mathematics4 Life OrientationorMathematicsMathematical LiteracyMathematics is compulsory for subjects marked with * and is recommended for subjects marked with ** 5 Select at least three elective subjects(Included in package price)You may select a maximum of two additional elective subjects at an extra cost. If the learner made a subject change, the applicable motivation and catch-up plan on page 6 must be StudiesDramatic Arts(English only)EconomicsGeography**Tour ismVisual ArtsAccountingEngineering Graphics and Design**Life Sciences**Physical Sciences* Agricultural Management PracticesComputer Applications Technology1 Information Technology** 1 2(English only)HistoryAgricultural Sciences**orConsumer StudiesHospitality StudiesPractical assessment may involve additional costsFET PHASE grade 10 grade 10 With submitting this registration form, I declare that:The learner is at the required standard to progress to grade 10.

7 (Policy dictates that a learner must have achieved the required standards for successful completion of grade 9 prior to entering grade 10). In the event where a valid report is not available, the responsibility resides with me (guardian/parent) and I hereby confirm this learner s readiness and compliance with the grade 9 have familiarised myself with the rules regarding admission and subject choices contained in the grade 10 12 Critical Enrolment Information document (available on ).Declaration:Please note: The software required for Computer Applications Technology and Information Technology is not included. 1 MS Windows 7 or higher and MS Office 2013 or newer with MS Access is Scratch and Delphi 10 are language of lesson material1 subject selection: grade 10 AfrikaansEnglish(English by default, if no option is selected)Examination board registration (compulsory)Additional subjects (optional)R2 071 per subject (Excludes examination board registration)Other costsR23 per subject (not included in above-mentioned prices) grade repeater:YesNoWhere did you hear about Impaq?

8 Please note that an online registration process for this and other options is available on our website ( ).Package selection: FET PHASE grade 11 Page 4 of 11 Examination board registration (compulsory)Additional subjects (optional)R2 071 per subject (Excludes examination board registration)Other costsR105 per subject (not included in above-mentioned prices)Select two languages(at least one home language)2 English Home LanguageEnglish First Additional LanguageAfrikaans HuistaalAfrikaans Eerste Addisionele TaalororandCompulsory subjects3 Select your Mathematics4 Life OrientationorMathematicsMathematical LiteracyMathematics is compulsory for subjects marked with * and is recommended for subjects marked with ** 5 Business StudiesDramatic Arts(English only)

9 EconomicsGeography**Tour ismVisual ArtsAccountingEngineering Graphics and Design**Life Sciences**Physical Sciences* Agricultural Management PracticesReligion StudiesComputer Applications Technology1 Information Technology** 1 2(English only)HistoryAgricultural Sciences**orConsumer StudiesHospitality StudiesPractical assessment may involve additional costsFET PHASE grade 11 Declaration:Please note: The software required for Computer Applications Technology and Information Technology is not included. grade 11andI have familiarised myself with the rules regarding admission and subject choices contained in the grade 10 12 Critical Enrolment Information document (available on ).

10 The learner has successfully completed grade 10 on the CAPS curriculum and the valid, final report is attached. If registering before January 2019 and the final report card is not available the learner will only be considered for provisional approval if a passed Term Two report card is submitted during registration. When the final report card is available; I accept the responsibility of submitting it to Impaq before the end of January 2019. I understand that the application will only be accepted provisionally and, should I fail to submit a final report for grade 10, the learner s registration may be cancelled. (The Cancellation Policy will apply). 1 MS Windows 7 or higher and MS Office 2013 or newer with MS Access is Delphi 10 is at least three elective subjects(Included in package price)You may select a maximum of two additional elective subjects at an extra cost.