Attendee Registration Form – North Crest Academy

Study Year Applying For *

Details of Student

Applying For *

Surname *

Full Names *

ID Number *

Gender *

Place of Birth *

Last School Attended *

Medical Aid Name

Name of Doctor *

Details of First Parent / Guardian

Known As

Home Language *

Citizenship

Lurits Nr

Date of Birth *

Grade Applied *

Member Number

Tel No of Doctor *

Relationship to Student *

Surname *

ID Number

Postal Address *

characters

Company *

Tel No (W)

Fax No

Marital Status *

Details of Second Parent / Guardian

Title *

Full Names *

Residential Address *

characters

Occupation *

Tel No (H)

Cell No *

Email Address *

Relationship to Student

Surname

ID Number

Postal Address

characters

Company

Tel No (W) *

Cell No

Marital Status

Title

Full Names

Residential Address

characters

Occupation *

Tel No (H)

Fax No

Email Address

Legal Custody *In the event of divorce, please indicate who gets legal custody of the child

Additional Emergency Contact

Surname *

Relationship to Student *

Scholastic Particulars

Full Names *

Cell No *

Denial of Admission *Has this child ever been refused admission or been expelled from another school?

School(s) If so, give the name(s) of the school(s)

Intoxicants *Has the child ever used drugs / using drugs at present?

Medical Particulars of Student

Allergies if Any Please Explain

Please indicate against which of the following diseases he / she has been immunised

Not Mentioned Above Name of any other disease against he / she has been immunized which is not listed above

Disabilities Please name any disabilities of the student

Pregnant *Is the student (girl) currently pregnant?

Visitors

Months

Name and Surname

Name and Surname

Subjects - Grade 1 - 9

ID Number

Relationship to Student

Language Choices: Grade 1 - 3

English Home Language
Afrikaans First Additional

Subjects - Grade 10 - 12

Language Choices: Grade 4 - 9

English Home Language
English First Additional
Sepedi Home Language
Afrikaans First Additional

Home Language

Mathematics

1st Subject

3rd Subject
Subject Changes - Grade 11 - 12

First Additional Language

Life Subjects

2nd Subject

Literacy Subjects

Old Subject

Old SubjectPlease Note:
Grade 11: May change 2 subjects only
Grade 12: May change 1 subject only

Student Portal Sign Up

New Subject

Email Address * Please provide us with an email address which you have access to which we can use to communicate with you you.

Confirm Email *

Create a Password * Please create a memorable password as it will be used to log into your student portal

Confirm Password *