Learskool Bekker Application Form – Laerskool Bekker Primary

Application for Bekker Primary

Please complete the form below. Note that the fields will automatically update based on your selections (e.g., School or Hostel, New Application or Re-application). Please follow all instructions carefully as they appear.

Documents to Upload:

Please ensure you have clear, certified copies of the Learner’s Birth Certificate, Latest Report Card, Parent/Guardian IDs, and Proof of Residence/Work Address ready.

SECTION A: LEARNER(S) DETAILSThis form must be completed in full by the Parent, Guardian or Proxy.

Application Type *

Applying for Hostel? *

Learner Full Name & Surname *

RSA-Citizen *YesOther

Date of Birth *

Learner ID Number *(or Passport Number if not SA citizen)

Learner Gender *

Grade Applying For: *Please use the grade you are applying for and not the current grade.

Current School *

Parent / Guardian (1) Relationship With Learner *

Parent / Guardian (2) Relationship With Learner

Learner Age

SECTION A.1: HOSTEL APPLICATIONThis form must be completed in full by the Parent, Guardian or Proxy.

For Proxy Applicants: Has the parent or legal guardian authorized this application for hostel placement, and do they formally accept responsibility for the payment of all hostel fees in advance? *YesNoThe applicant is solely responsible for the payment of all hostel fees. Note: Hostel fees are separate from school fees; as such, payments must be made into their respective designated accounts.

Learner Full Name & Surname *

Reason for Hostel Placement *

Disciplinary History *Has the learner ever been subject to a formal disciplinary hearing at their current or previous school?

Please provide details on the Disciplinary History *

Medical Aid & Dietary Information

Note: This section is vital for our hostel staff to ensure your child’s safety and wellbeing. Please complete all fields; if a specific field does not apply to your child, please enter "N/A".

Medical Aid Name *

Policy Number *

Main Member Name *

No Family DoctorWe do not have a Family Doctor

Family Doctor *

Family Doctor Number *

Allergies *

Chronic Medication *

Special Dietary Requirements *

Weekend & Travel Arrangements

Who will collect the learner on weekends? *

5. Financial Commitment & Declaration

Since hostel fees are often separate from school fees, this part must be clear.

AGREEMENT OF RESPONSIBILITY

I understand that hostel fees are payable in advance.
I agree to abide by the Hostel Code of Conduct and Rules.
I acknowledge that the school/hostel is not liable for the loss of personal property.
(For Proxies): I confirm that the legal parent/guardian has authorized this placement and accepts financial responsibility.

SECTION B: PARENT, GUARDIAN, OR PROXY DETAILS

N.B. This form must be completed in full by the Parent Guardian Proxy.

Personal Details Parent / Guardian One (1)This section refers to the first parent, legal guardian, or primary caregiver. This person will be the school’s first point of contact.

Prefix

First Name *

Middle Name

Last Name *

RSA-Citizen *YesOther

Identity number of Parent/Guardian 1 *0 / 13

Parent/Guardian 1 Email Address *

Confirm Email Address *

Parent/Guardian 1 Cell Number *This number will be used in case of an emergency.

Parent/Guardian 1 Employer *

Parent/Guardian 1 Occupation *

Physical Business Address of Employer *

Parent/Guardian 1 Employer Number *

Personal Details Parent / Guardian Two (2)

Prefix

First Name

Middle Name

Last Name

RSA-CitizenYesOther

Identity number of Parent/Guardian 20 / 13

Parent/Guardian 2 Cell Number

Parent/Guardian 2 Email Address

Confirm Email Address

Parent/Guardian 2 Occupation

Parent/Guardian 2 Employer

Parent/Guardian 2 Employer Number

Document Upload

Please upload the following documents to proceed: *

Learner Documents: Birth Certificate and latest Report Card. Identification: Parent/Guardian ID. (Please include Proof of Guardianship if applicable). Proof of Residence: * Homeowners: Municipal account (< 3 months old). Tenants: Signed lease agreement + landlord’s ID and municipal account. Proof of Work Address: Recent payslip or stamped employer letter. Privacy Note: We are committed to protecting your family's privacy. These documents are collected solely for registration and will be handled with strict confidentiality. Note: If further documentation is needed, our office will contact you.

UNDERTAKING BY PARENTS / GUARDIAN / PROXY

TRANSPORT

1. I am aware that the hostel is closed during the school holidays and on weekends, and that it is my responsibility to provide transport for my child to and from the hostel at my own expense. I am also aware that children must be fetched latest at 18:00 on a Friday.

2. I undertake to notify the responsible officer immediately of any change in address, telephone numbers etc. I undertake to abide by the rules and regulations. I undertake not to sue the school hostel or staff for any damages should my child/ren by injured in sport or in extramural activities to which I consented, or any transport where school activities are involved.

UNDERTAKING BY PARENTS / GUARDIAN / PROXY

1. Hostel regulations and rules:

I am aware that my child’s admission is subject to hostel regulations, as well as the rules of the hostel.

I am prepared to comply with the above and undertake to :

a) Pay the boarding fees regularly and in advance every month before the 7th.

b) Give a full MONTH’S notice before I remove my child from the hostel;

c) Compensate / Pay for, any damages caused by my child, whatever it may be.

TRANSPORT

1. I am aware that the hostel is closed during the school holidays and on weekends, and that it is my

responsibility to provide transport for my child to and from the hostel at my own expense. I am also

aware that children must be fetched latest at 18:00 on a Friday.

2. I undertake to notify the responsible officer immediately of any change in address, telephone

numbers etc. I undertake to abide by the rules and regulations. I undertake not to sue the school

hostel or staff for any damages should my child/ren by injured in sport or in extramural activities to

which I consented, or any transport where school activities are involved.