VODACOM MILLIONAIRES MOBILE COMPUTER …

1 Page 1 of 4 VODACOM MILLIONAIRES COMPUTER Centre application form VODACOM MILLIONAIRES MOBILE COMPUTER CENTRE GIVEAWAY FAX APPLICATION FORM Date : To : From : VODACOM MILLIONAIRES Fax : Pages : 4 (including cover) Phone : Phone : 082 276 2036 Re : VODACOM MILLIONAIRES MOBILE COMPUTER Centre Give Away Draw Fax : (011) 546 8249 Dear Principal: VODACOM MILLIONAIRES gives away a MOBILE COMPUTER centre to 4 public schools every month. All application forms go into a monthly draw, and once a month 4 lucky schools win a COMPUTER centre. If you would like to enter your school for the VODACOM MILLIONAIRES MOBILE COMPUTER centre give away fill out the form attached and fax it back to us.

2 Watch VODACOM MILLIONAIRES game show every Tuesday at 18:26 on SABC1 and see if you are one of the 4 lucky schools to receive a COMPUTER centre. Schools that do not have a COMPUTER centre and schools in rural areas will be given priority; however entries from schools that have a COMPUTER centre will be kept on file for a year. All VODACOM customers receive 2 FREE SMS to play VODACOM MILLIONAIRES every week. To win a million rand SMS 9 letters (A-Z) to 32082 and watch the draw on SABC1 Tuesday at 18:26 Please ensure all information is completed correctly in a neat legible handwriting, as incomplete or incorrectly applications will not be entered into the VODACOM MILLIONAIRES MOBILE COMPUTER Centre draw.

3 Please fax or mail your completed application form, plus a handwritten map of the school location to (011) 546 8249 or mail it to If you have any further queries, call 082 24 32082 for free from your VODACOM cell phone. Good luck on your application! The VODACOM MILLIONAIRES Team Page 2 of 4 VODACOM MILLIONAIRES COMPUTER Centre application form 1. SCHOOL INFORMATION (please note all the information bellow is compulsory) *Name : *EMIS Number : *School Physical Address : *Postal Code : *School Telephone Number : ( code ) ( number ) *School Fax Number : ( code ) ( number ) *School Postal address : *Postal Code : *Town/City : *Province : *Municipality : Yes No *Is your school a public school?

4 : Yes No *Is your school a Primary or High School? : Primary High *How many teachers work at the school? : *How many pupils attend the school? : *What is the current Matric Pass Rate? : *School district 2. EXISTING INFRASTRUCTURE Do you have a COMPUTER centre at the school? : Yes No Does the school have a COMPUTER for administrative purposes? : Yes No Do you have a printer? : Yes No Do you have Internet connectivity? : Yes No 2. ELECTRICITY REQUIREMENTS Does your school have electricity? : Yes No If not, what energy sources do you use to generate electricity?

5 : 3. MOBILE COMPUTER CENTRE - ROOM REQUIREMENTS Please note: In order to qualify for the COMPUTER Centre, your school has to meet the below requirements at your own cost. Do you have a secure room or a walking in save to store the MOBILE COMPUTER center? Do you have secure burglar bars doors, windows & alarm? : Yes No Page 3 of 4 VODACOM MILLIONAIRES COMPUTER Centre application form 4. Teacher Requirements Are there teachers willing to be trained on how to use the MOBILE COMPUTER lab for 2 days? : Yes No How many teachers are willing to be trained? : List contact details of 3 educators at the school. : 1. Principal Name : Cellphone number : Office number : ( code ) ( number ) Fax number : ( code ) ( number ) E-mail address (if any) : ID Number (Please attach copy) : 2.

6 Deputy Principal : Name : Cellphone number : Office number : ( code ) ( number ) Fax number : ( code ) ( number ) E-mail address (if any) : 3. Educator : Name : Cellphone number : Office number : ( code ) ( number ) Fax number : ( code ) ( number ) E-mail address (if any) : Who nominated the school to MILLIONAIRES : Persons name and Surname 5. Declaration I, (Headmaster's name and surname) : declare that information in this form is true in all respects. Headmaster signature : Date of the application : Cellphone number : Page 4 of 4 VODACOM MILLIONAIRES COMPUTER Centre application form School Stamp : Please draw a map of the school location and include the nearest village or town for easy access.