Inskrywingsvorm / Enrolment form R500 Registrasie fooi – Nie-Terug Betaalbaar R500 Registration fee – Non-Refundable Reg fooi ontvang/Reg fee received:_________ Datum van inskrywing / Date of enrolment___________________________________ Van / Surname________________________________________________________ Naam van kleuter / Name of Child_________________________________________ Ouderdom / Age__________ Geboortedatum / Date of Birth____________________ Geslag / Sex_____________ Huistaal / Home Language_______________________ Huis / Home Tel____________________ Straatadres / Street Address Posbus /P.O.Box ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ Vader /Father______________________Moeder/Mother_______________________ ID Nommer:_______________________ID Nommer:__________________________ Beroep / Occupation_________________Beroep /Occupation___________________ Werkgewer/Employer________________Werkgewer/Employer__________________ Werk/Work Tel_____________________Werk/Work Tel________________________ Sel/Cell___________________________Sel/Cell_____________________________ E-pos/E-mail:______________________ E-pos/E-mail:________________________ Vorige skool bygewoon/Previous school attended_____________________________ MEDIESE GESKIEDENIS / MEDICAL HISTORY Allergië/Allergies_______________________________________________________ Algemene gesondheid / General health_____________________________________ Mediese probleme / Medical problems______________________________________ Huisdokter/Family practitioner_______________________Tel___________________ Mediese Fonds/Medical Aid_________________________Nr___________________ Hiermee gee ek toestemming dat my huisdokter gekontak mag word i.g.v. nood Herewith permission to contack my family practitioner in case of emergency. ____________________________________________________________________ Signature Naam van ander persoon buiten uself wat kleuter by die skool mag kom haal. Name of person other than yourself who is allowed to fetch child from school. ____________________________________________________________________ Stuur asb! Afskrifte van ID (Ouers), geboortesertifikaat (kind)en immuniseringskaart Please send! Copies of ID(parents, birth certificate (child) and immunisationcard. Please note that Woelwater’s Mother tongue is Afrikaans and that all meetings and the concert is done in Afrikaans. Neem kennis dat Woelwater se voertaal Afrikaans is en dus geskied alle vergaderings en die konsert in Afrikaans. Handtekening van ouer/voog:…………………… Signature of parent/guardian:……………..… Pre-primary School Pre-primêre Skool Posbus 13 P.O.Box 13 Amanzimtoti 4125 Tel: 031 904 1821 Cell: 079 699 4374 Fax: 031 904 1853 Email: [email protected]
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Reg fooi ontvang/Reg fee received:_________ Datum van inskrywing / Date of enrolment___________________________________ Van / Surname________________________________________________________ Naam van kleuter / Name of Child_________________________________________ Ouderdom / Age__________ Geboortedatum / Date of Birth____________________ Geslag / Sex_____________ Huistaal / Home Language_______________________ Huis / Home Tel____________________ Straatadres / Street Address Posbus /P.O.Box ____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________ Vader /Father______________________Moeder/Mother_______________________ ID Nommer:_______________________ID Nommer:__________________________ Beroep / Occupation_________________Beroep /Occupation___________________ Werkgewer/Employer________________Werkgewer/Employer__________________ Werk/Work Tel_____________________Werk/Work Tel________________________ Sel/Cell___________________________Sel/Cell_____________________________ E-pos/E-mail:______________________ E-pos/E-mail:________________________ Vorige skool bygewoon/Previous school attended_____________________________ MEDIESE GESKIEDENIS / MEDICAL HISTORY Allergië/Allergies_______________________________________________________ Algemene gesondheid / General health_____________________________________ Mediese probleme / Medical problems______________________________________ Huisdokter/Family practitioner_______________________Tel___________________ Mediese Fonds/Medical Aid_________________________Nr___________________ Hiermee gee ek toestemming dat my huisdokter gekontak mag word i.g.v. nood Herewith permission to contack my family practitioner in case of emergency. ____________________________________________________________________ Signature Naam van ander persoon buiten uself wat kleuter by die skool mag kom haal. Name of person other than yourself who is allowed to fetch child from school. ____________________________________________________________________ Stuur asb! Afskrifte van ID (Ouers), geboortesertifikaat (kind)en immuniseringskaart Please send! Copies of ID(parents, birth certificate (child) and immunisationcard.
Please note that Woelwater’s Mother tongue is Afrikaans and that all meetings and the concert is done in Afrikaans.
Neem kennis dat Woelwater se voertaal Afrikaans is en dus geskied alle vergaderings en die konsert in Afrikaans.
Handtekening van ouer/voog:…………………… Signature of parent/guardian:……………..…
ONS, die ondertekendes, WE, the undersigned VADER_________________________________________(Volle name en van) FATHER (Full names and surname) MOEDER________________________________________(Volle name en van) MOTHER (Full names and surname) Van /of ________________________________________________ Volle name van kleuter Full names of child hiermee vrywaar en stel skadeloos / hereby indemnify and hold harmless Woelwater Pre-Primêre skool (insluitende die personeel, werknemers, agente, beheerraad en kontrakteurs) van enige eise, verliese, skade en kostes wat ontstaan weens die dood of besering van my kind, en van enige verliese of skade aan eiendom van watter aard ookal en hoedanig ookal opgedoen, insluitende gevolgskade, terwyl my kind hom/haar mag bevind onder die beheer ent toesig van Woelwater Pre-Primêre skool. Woelwater Pre Primary school (including personnel, employees, agents, governing body and contractors) against any claims, losses, damages, costs or demand arising from the death of or injury to my child or any loss of or damage to property, of whatsoever nature and howsoever sustained, including consequential loss, whilst my child is in the care and under the control of Woelwater Pre Primary school. OUER HANDTEKENING /PARENT’S SIGNATURE VADER/FATHER________________________ID NR:______________________________ MOEDER/MOTHER______________________ID NR:_____________________________
1. Hiermee onderneem ek: Vader:____________________________,(Volle name en van)
ID nommer:________________________________, en
Moeder:_________________________________________,(Volle name en van)
ID nommer:______________________________________, om die skoolfooie, soos deur
die Beheerraad vasgestel, per debiet order en maandeliks vooruit en nie later as op die 1ste
dag van die maand vir elke daaropvolgende maand te betaal solank as wat my/ons kleuter by
Woelwater Pre-Primêr skoolgaan.
2. Ek stem in om een (1) kalendermaand skriftelik kennis te gee, sou my kleuter die skool
verlaat en aanvaar dat ek ook verantwoordelik is vir die betaling van skoolfooi vir die kennis maand.
3. Ek bevestig ook dat ek kennis dra van die rëel dat indien my skoolfooie nie ten volle tot op
datum betaal is voor of op die 7de van elke maand nie, my kleuter sy/haar plek in die skool met onmiddelike effek sal verloor totdat alle agterstallige fooi opbetaal is.
4. Ek gee hiermee toestemming dat Woelwater Pre-Primêre Skool my persoonlike details asook
die besonderhede van hoe ek die betaling van my kind se skoolfonds en ander finansiële
verpligtinge teenoor Woelwater Pre-Primêre Skool nagekom het, mag oordra en kommunikeer
aan enige geregistreerde kredietburo, in die geval van wanbetaling. Ek gee ook hiermee
toestemming dat sodanige inligting deur alle sodanige geregistreerde kredietburos gedeel
mag word asook deur enige ander persoon soos bedoel in die Nasionale Kredietwet (34/2005)
5. Ek gee hiermee toestemming aan Woelwater Pre-Primêre Skool om jaarliks my debietorder
aan te pas ooreenkomstig die eskalasie van die skoolfooie.
MAGTIGING VAN ALTERNATIEWE PERSOON OM MY/ONS KLEUTER(S) NAMENS MY/ONS TE KOM AFHAAL BY DIE SKOOL
Hiermee gee ek,…………………………………… en ………………………………………….. (Naam van Vader) (Naam van Moeder) toestemming dat my/ons kleuter(s): ……………………………………………………. ………………………………………..…… Naam van kleuter Groep …………………………………………………….. …………………………………………… Naam van kleuter Groep …………………………………………………….. …………………………………………… Naam van kleuter Groep saam met die volgende Persoon/Persone mag saam gaan; indien ek self nie betyds sal wees om my kleuter(s) by die skool te kom oplaai nie: Genomineerde Persoon: Naam & Van: ……………………………………. ID Nr.: …………………………………………. Naam & Van: ……………………………………. ID Nr.: …………………………………………. Ek sluit hiermee ‘n afskrif van die Genomineerde persoon/persone se ID dokument in. Geteken te …………………………….. op hierdie ……………….van ……………… 20……. . …………………………………. ………………………………….. Handtekening van Vader/Voog Handtekening van Moeder/Voog
NOMINATION OF AN ALTERNATIVE PERSON TO COLLECT MY/OUR CHILD/CHILDREN FROM SCHOOL ON MY/OUR BEHALF
I/We,…………………………………… and ………………………………………….. (Name of Father) (Name of Mother) Hereby give consent that my/our child/children: ……………………………………………………. ………………………………………..…… Name of child Group …………………………………………………….. …………………………………………… Name of child Group …………………………………………………….. …………………………………………… Name of child Group May be collected by the nominated person/s on my behalf from School in the case where I/we can not be there to collect my/our child/children by myself/ourselves. I/We hereby nominate the following person(s) to do so on my/our behalf: Nominated Person: Name & Surname: ……………………………………. ID Nr.: ……………………………………. Name & Surname: ……………………………………. ID Nr.:……………………………………. I hereby attached hereto a copy of the above mentioned nominated person’s ID document. Signed at …………………………….. on this day the …….of ……………… 20……. . …………………………………. ………………………………….. Signature of Father/Guardian Signature of Mother/Guardian
Naam van rekening: Woelwater Pre-Primêre Skool Name of account: Woelwater Pre-Primary School ABSA bank: Amanzimtoti Account Nr: 3300145786 Branch Nr: 632 005 Account type: Cheque Reference: Child’s surname & name
School fees are payable by debit order, monthly in advance and not later than on the 1st day of the month for every consecutive month for as long as your child is enrolled in Woelwater Pre-primary School.
The following fees is payable once off on or before the 31st of January 2017 and is not
part of the school fees:
Facecloth & Mug fee R 30.00
Presentations for the year R 350.00 (2yrs to 6 yrs)
Communication book & cover R 30.00
Total amount payable: (once off on or before the 31st
of
January 2017) R 410.00 per child
School readiness: Gr. 0 and Gr. 00 Children: (Children cannot start with school readiness if the following fee has not been paid).
Gr 0 fee (once off): R 450.00 per child
Gr 00 fee (once off): R 400.00 per child
*Fundraising fee once off payable on or before the 28th of February 2017:
R 500.00 per child
*Consumables fee once off payable on or before the 28th of February 2017:
R 200.00 per child
Total once off payment per child payable on or before the 28th of February 2017:
R 700.00 per child
* In the past it was found that only a small number of parents are involved in fundraising efforts and contribute
consumables such as toilet paper, tissues etc. It was therefore decided and agreed to raise a fundraising and
consumables fee in order to spread the responsibilities of fundraising and consumables amongst all parents.
AFTERCARE:
I/we hereby notify the school that my/our child(ren) will/will not be attending aftercare:
Yes, I/we am/are enrolling my/our child(ren)
to attend aftercare and will be paying the full
day fee.
No, I/we am/are not enrolling our child(ren)
to attend aftercare and we will be paying the
half day fee.
(Please indicate your choice with an “X” in the appropriate block).
Page 7 of 8
TERMS AND CONDITIONS:
1 I (Father/guardian) _________________________________________ (Full name
and surname), with Id nr._______________________, and
I (Mother/guardian) ______________________________________ (full name and
surname), with Id nr._______________________,
as parent(s)/guardian(s) of
NAME OF CHILD(REN):
1.________________________________ DATE OF BIRTH: _____________________
2.________________________________ DATE OF BIRTH: _____________________
3.________________________________ DATE OF BIRTH: _____________________
Undertake and bind myself:
(a)
Option 1 To pay the school fees for 2017 with a once-off payment of
R______________________ per child on or before 31 January 2017.
Option 2 To pay the school fees for 2017 per debit order with a monthly
instalment of R_____________ , in advance on the first day of every
month, starting on 1 January 2017 and then every first day of the
month for each following month, with the last instalment on 1
November 2016
(b) (if you choose option 2 above), to correctly complete the attached debit order form (if you have not completed the debit order form yet) and to return it by no later than the first day of your child’s school day, to the school’s administration office or via e-mail,
(c) (if you chose option 2 above) that I hereby give permission that Woelwater may
adjust my debit order annually according to the escalation of school fees as
determined by Woelwater Pre-Primary School.
(d) that I hereby consent to Woelwater Pre-Primary School transmitting details of how I
have performed in meeting my obligations in terms of school fees payable to
Woelwater Pre-Primary, including personal information, to all registered credit
bureaux and I hereby consent that such information may be shared by all such
registered credit bureaux and any other person as contemplated by in the National
Credit Act (34 of 2005), for the prescribed purposes of the Act.
Page 8 of 8
(e) to give one calendar months’ notice in writing (aftercare included) should my child for
any given reason leave the school and that I will be responsible for the payment of
the school fee for the notice month.
(f) that in the case where any instalment(s) according to this agreement is not paid on or
before the specific date, the school will void this agreement straightaway and that the
full outstanding amount will be payable immediately.
________________________ as my/our chosen legal domicile for service of all legal
notices and processes until I/we advise the school in writing, which written notice
must be received by the school, of my/our new address, which will then become our
new legal domicile.
Signed at ___________________________ (place) on _____________________ (date)
___________________ _____________________
Father/Guardian Mother/Guardian
Signed at ___________________________ (place) on _____________________ (date)
____________________
Principal
STRATCOL USER NO: 8237 STRATCOL USER NAME: Woel Water Pre-Primere skool STRATCOL ABBREVIATED NAME: SAVF (This will be the name appearing on your Bank statement)
Woelwater Pre Primere Skool - SLEGS KANTOORGEBRUIK
EFT Kleuter naam en van : __________________________________
DEBIETORDER MAGTIGING
BESONDERHEDE VAN REKENINGHOUER: ID Nommer / Registrasienommer: _____________________Naam & Van / Naam v Besigheid: _______________________________________ Adres: ____________________________________________________________________________________________Kode____________ Kontak Besonderhede: ___________________________ (Huis) ___________________________ (Sel) ________________________ (Werk) Indien ‘n Besigheid, Naam van gemagtigde persoon vir die teken hiervan: ________________________________________________________ Rekeninghouer: ___________________________________________________ Bank: ______________________________________________ Takkode: ______________________________Rekeningnommer: _______________________________________________________________ Rekeningtipe: Besonderhede indien ANDER: ______________________________ : _____________________________
KOLLEKSIE INSTRUKSIE: Interval:
Is dit ‘n vaste bedrag of kan die bedrag wissel in die toekoms? Vaste Bedrag:
Wisselende Bedrag: Nota: Indien Wisselend, mag die bedrae hieronder (indien ingevul) oorskry word. * Eenmalige Aftrekking:
Kolleksiedatum: dd_____ /mm _____ / 20_____ R _____________. _______ (Bedrag)
* Herhalende Aftrekking: Herhaal die aftrekking onbepaald tot gekanselleer deur die kliënt? JA NEE
1ste Kolleksiedatum: dd_____ /mm _____ / 20_____ R _____________. _______ (Bedrag) Dag van Kolleksie daarna: ___________ (1-31)
* Weekliks: MA / DI / WO / DO / VR / SA Ek / Ons, die kliënt of behoorlike gemagtigde veteenwoordiger, gee hiermee goedkeuring aan StratCol om d.m.v ‘n elektroniese debietorder van die bogenoemde rekening te vorder, en om genoemde gelde oor te betaal aan die Stratcol gebruiker soos bo genoem. (Ek / Ons bevestig dat Ek / Ons die gemagtigde persone is vir die teken en magtiging van hierdie debietorder, met handtekening magtigings soos by My/ Ons bank geregistreer.
OOREENKOMS Ek / Ons gee hiermee toestemming aan STRATCOL om betaling instruksies uit te reik aan my /ons bankier vir die kolleksie teen my /ons bogemelde bankrekening by my /ons bank.
Die individuele betaling instruksies soos gemagtig, moet uitgereik en afgelewer word volgens die bogenoemde interval en op die datum wanneer die verpligting in terme van die ooreenkoms verskuldig is. Die bedrag van elke individuele instruksie kan nie verskil van dit wat hierin vervat word nie.
Die betaling instruksies soos gemagtig moet uitgereik word met 'n verwysings nommer, welke verwysing in die betalings instruksie ingesluit moet word om my / ons in staat stel om dien ooreenkoms die debiet op my / ons bankstaat te identifiseer. Die genoemde nommer moet aan hierdie vorm bygevoeg soos onder bladsy 1 aangedui is by kliënt verwysingsnommer en moet voor die uitreiking van enige betalingsopdrag en aan my / ons gestuur word direk nadat dit voltooi is deur my / ons.
Ek / Ons stem saam dat die eerste betaling opdrag uitgereik sal word en afgelewer soos per kolleksie instruksie. In die geval waar die relevante rekening nie genoegsame beskikbare fondse het om enige debiet te dek nie, is ek bewus dat n fooi gehef sal word teen my bank rekening vir die terugsending. Ek aanvaar die verantwoordelikheid om genoegsame en beskikbare fondse gelykstaande aan die minimum bedrag soos hierbo genoem te verseker (of soos aangepas van tyd tot tyd).
As die datum van die betaling instruksie egter op 'n nie – erkende bankdag val (naweek of openbare vakansiedag) stem ek / ons in dat die betaling instruksie teen my / ons rekening op die volgende of die vorige werkdag ingestel kan word.
MANDAAT:
Ek / ons erken dat alle betaling instruksies uitgereik deur die STRATCOL gebruiker sal hanteer word deur my / ons bogenoemde bank asof die instruksies persoonlik uitgereik is deur my / ons.
KANSELASIE:
Ek / Ons stem in dat hoewel hierdie gesag en mandaat gekanselleer mag word deur my / ons, sodanige kansellasie nie die ooreenkoms sal kanselleer nie. Ek / Ons verstaan ook dat ek / ons nie bedrae, wat uit my / ons rekening (betaal) onttrek is, in terme van hierdie instruksie mag herroep indien sodanige bedrae wettiglik verskuldig was aan die STRATCOL gebruiker nie.
OORDRAG:
Ek / ons erken dat hierdie gesag gesedeer kan word aan 'n derde party indien die ooreenkoms ook gesedeer word aan daardie derde party.
GETEKEN TE _______________________________ OP HIERDIE ________ DAG VAN ___________________ 20_____.
STRATCOL USER NO: 8237 STRATCOL USER NAME: Woel Water Pre-Primere skool STRATCOL ABBREVIATED NAME: SAVF (This will be the name appearing on your Bank statement) STRATCOL USER PHYSICAL ADDRESS: Posbus 13, Amanzimtoti, 4125 031 904 1821 fax: 031 904 1853/ 086 5400 460 [email protected] : www.woelwater.co.za
Woelwater Pre Primere Skool - SLEGS KANTOORGEBRUIK
EFT Kleuter naam en van : __________________________________
DEBIT ORDER AUTHORISATION
ACCOUNT HOLDER (DEBTOR) INFORMATION: ID Number / Registration Number: ________________________ Name & Surname / Company Name: _________________________________ Address: ____________________________________________________________________________________________Code____________ Contact Details: ___________________________ (Home) ___________________________ (Mobile) ___________________________ (Work) If Company / CC, Name of Person(s) signing this: ____________________________________________________________________________ Account Holder Name: ______________________________________________ Bank: ______________________________________________ Branch / Code: ______________________________Account Number: ___________________________________________________________ Account Type: If “Other” supply details: _______________________________ : _______________________________
COLLECTION INSTRUCTION: Interval:
Is this limited to fixed amounts, or to debits due in future that may vary? Fixed amounts:
Variable amounts: Note: if variable, the amount(s) hereunder may be exceeded. * Once off transaction:
* Recurring transactions: CONTINUE INDEFINATELY UNTILL CANCELLED BY DEBTOR? YES NO
1
st Collection date: dd_____ /mm _____ / 20_____ R _____________. _______ (Amount)
Day of Month thereafter: ___________ (1-31) Annual escalation: _______ (%) Escalation month: _____________
* If not indefinitely: _____________ (number of deductions) dd_____ /mm _____ / 20_____ (Final date) * If weekly: MON / TUE / WED / THU / FRI / SAT I / We, the above mentioned and undersigned, hereby authorise StratCol to collect by debit order from the above mentioned bank account, all amounts due in terms hereof and to pay same to the Stratcol User above. (I confirm that I / we are the person(s) with signature authority as registered with my / our bank).
I/we hereby authorise STRATCOL to issue and deliver payment instructions to my / our banker for collection against my/our abovementioned account at my/our abovementioned bank.
The individual payment instructions so authorised to be issued, must be issued and delivered according to the abovementioned interval on the date when the obligation in terms of the Agreement is due and the amount of each individual payment instruction may not differ as agreed to in terms of the Agreement.
The payment instructions so authorised to be issued, must carry a number, which number must be included in the said payment instruction and if provided to me / us should enable me / us to identify the agreement on my / our bank statement. The said number should be added to this form on page 1 under client reference number, before the issuing of any payment instruction and communicated to me / us directly after having been completed by me / us.
I/we agree that the first payment instruction will be issued and delivered as per collection instruction. In the event of the relevant account not having sufficient cleared funds to meet any debit, I am aware that an unpaid fee will be debited against my account by the bank and an additional unpaid fee will be charged by Sample relating to the return of the debit. I accept the responsibility to ensure sufficient cleared and available funds to the minimum of the limit above (or as amended from time to time).
If however, the date of the payment instruction falls on a non-processing day (weekend or public holiday) I / We agree that the payment instruction may be debited against my / our account on the following or previous business day.
MANDATE
I / we acknowledge that all payment instructions issued by the Stratcol User shall be treated by my / our abovementioned bank as if the instructions had been issued by me / us personally.
CANCELLATION
I / we agree that although this authority and mandate may be cancelled by me / us, such cancellation will not cancel the Agreement. I / we also understand that I / we cannot reclaim amounts, which have been withdrawn from my / our account (paid) in terms of this authority and mandate if such amounts were legally owing to the Stratcol User.
ASSIGNMENT
I / we acknowledge that this authority may be ceded or assigned to a third party if the Agreement is also ceded or assigned to that third party.
SIGNED AT ___________________________________ ON THIS ________ DAY OF ___________________ 20_____.