2019 APPLICATION FOR UNDERGRADUATE ADMISSION - UCT Students
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FOR OFFICE USE
CAMPUS ID
EMPL ID:
2019 APPLICATION
FOR UNDERGRADUATE
ADMISSION
SURNAME:
FIRST NAME:
• Apply online. Use this booklet only if you do not have access to the internet.
• If you are currently registered at UCT, and wish to transfer to another undergraduate
programme, you must consult the Faculty that you wish to transfer to.
• Complete this form using the information and codes found in the 2019 Directions for
Undergraduate Applicants.
• Please complete this form in CAPITAL LETTERS in ink.
• Return this completed form by post or in person. This form must not be faxed or emailed.
• DO NOT submit your application fee with this form. Refer to the 2019 Directions for
Undergraduate Applicants for instructions regarding application fee payments.SECTION A PERSONAL DETAILS
If you have applied to UCT before, enter your applicant/student number:
Title (Table H): Date D D M M Y Y Y Y
of birth:
Surname:
First name/s:
Preferred first
name:
Other former
last name:
Surname on
National Senior
Certificate (for
NSC writers only):
Sex: (please tick one) Female: Male: Trans: Home language (Table H):
Are you a South African citizen? Yes No Are you a South African permanent resident? Yes No
SA identity number:
If you are a citizen or permanent resident in a country other than South Africa, please provide details here:
Country (Table I): Citizenship status (please tick) Passport number (where available)
Citizen Permanent Resident
Citizen Permanent Resident
Citizen Permanent Resident
If you need assistance because of a disability, please specify the disability/ies (Table H) so we can plan to help you:
SECTION B NATIONAL BENCHMARK TEST (NBT) NUMBER
All applicants to undergraduate programmes normally resident, or at school, in South Africa, and all Health Sciences applicants, wherever resident, must
write the NBTs. If you are required to write the NBTs, you must register for NBTs before submitting this form. Enter your 14-digit NBT registration number
and, if you wrote before 2018, the year the NBTs were written. NBT results are only valid for two years prior to the year of application; so if you wrote
the NBTs in 2016 or 2017, the results remain valid but you may choose to rewrite in 2018.
NBT registration number:
Year written: 2 0 Y Y 2018 test date: D D M M
SECTION C PROGRAMMES OF STUDY FOR WHICH YOU ARE APPLYING
Choice Academic plan code (Table A) Only for Choice Academic plan code 2 (Table A)
Faculty of 1st Choice S B 0 0 1
1st Choice Science
applicants 2nd Choice S B 0 0 1
2nd ChoiceSECTION D YOUR CONTACT DETAILS
Home (street) address: Home (postal) address: (if different from home (street) address)
Postal/zip code: Postal/zip code:
Country tel code: Dialling code: Telephone number: Country tel code: Cellular number:
Email address:
SECTION E PARENT / GUARDIAN CONTACT DETAILS
Compulsory if you are under 18 years or if you are applying for financial assistance.
Title (Table h): Surname of parent/guardian:
First names of parent/guardian:
Home (street) address: Country tel code: Cell/mobile number:
Country tel code: Dialling code: Telephone number:
Postal/zip code:
Email address:
Identity/passport number of parent/guardian: Relationship to you:
Relationship code (Table J):
SECTION F FEE PAYER INFORMATION If your Fee Payer is also your parent/guardian, and you completed
Section E, you do not need to complete this section. If not, this section is compulsory.
Title (Table H): Surname of parent/guardian:
First names of parent/guardian:
Home (street) address: Country tel code: Cell/mobile number:
Country tel code: Dialling code: Telephone number:
Postal / zip code:
Email address:
Identity/passport number of parent/guardian: Relationship to you:
Relationship code (Table J):SECTION G REDRESS & DIVERSITY INFORMATION: SA APPLICANTS ONLY
This section applies to South African undergraduate applicants only and is compulsory.
The University’s redress and diversity policies apply to South African undergraduate applicants whose parent/s was/were classified under
apartheid as Black, Coloured, Chinese or Indian. Your responses to the following questions are used to calculate your redress category
and disadvantage factor. The disadvantage factor will be used in the calculation of your Weighted Points Score. Refer to page 8 of the
2019 Undergraduate Prospectus for an explanation of the University’s Admissions Policy.
1. Under apartheid, my mother was classified as (please tick only one):
Black Coloured Chinese Indian White Do not know
I choose not to answer this question My mother did not live under apartheid
2. Under apartheid, my father was classified as (please tick only one):
Black Coloured Chinese Indian White Do not know
I choose not to answer this question My father did not live under apartheid
3. What is/was your mother’s first language? (Table H)
Please tick one box in repect of each
4. What is or was the highest level of education of each of your parents or guardians? parent/guardian: (where applicable)
University or Technikon degree .................................................................................
University or Technikon certificate or diploma..............................................................
Technical College certificate, trade certificate or similar certificate...............................
Matric/Grade 12/Senior certificate..............................................................................
Some formal schooling..............................................................................................
No formal schooling..................................................................................................
I do not know . . ..........................................................................................................
5. Does or did at least one of your grandparents have:
A university qualification .. .........................................................................................
Yes No I do not know
A technikon degree or diploma...................................................................................
Yes No I do not know
6. Does or did your family receive a child-support grant on your behalf?. . ..........................
Yes No I do not know
7. Does or did your family rely on a social pension from the State?...................................
Yes No I do not know
SECTION H 2018 SECONDARY SCHOOL-LEAVING EXAMINATION DETAILS
Complete this section if you are writing a school-leaving examination in 2018. Supply only details of secondary schools located in South
Africa. If you attend school outside of South Africa, omit secondary school details.
School subjects to be written
School this year: Code Level
name: (Table D) (Table E)
(Table B) (Table C)
School Examining authority:
code:
School address:
Postal code:
For Cambridge International Examinations applicants: Centre no.: Candidate no.:
Did you attend any other secondary school before enrolling at your present school? Yes No
(Table B)
If yes, please provide the code If yes, in which year did you first
of your previous school: enrol at your present school: Y Y Y YSECTION I SECONDARY SCHOOL-LEAVING AND POST-SCHOOL INFORMATION
Complete this section if you have already left school. Supply only details of secondary schools located in South Africa. If you attended
school outside of South Africa, omit secondary school details. Please enclose certified copies of your certificates.
(Table B)
Last school School
attended: code:
School address: Date written:
D D M M Y Y Y Y
(Table C)
Postal code:
DETAILS OF ACTIVITIES SINCE LEAVING SCHOOL OTHER THAN TERTIARY EDUCATION
If you have left school and are not at a tertiary institution, you must complete this section.
Year Activity Code (Table F) Year Activity Code (Table F)
Y Y Y Y Y Y Y Y
Y Y Y Y Y Y Y Y
TERTIARY EDUCATION DETAILS
If you have attempted any tertiary education or are currently registered at a tertiary institution, you must complete this section. Please enclose
original transcripts or certified copies of your certificates/result statements.
Year of Degree / diploma for Qualification
School name: School code: (Table B) registration which registered completed
SECTION J HOUSING APPLICATION
Please tick the appropriate box to apply for UCT accommodation. (See 2019 Directions for Undergraduate Applicants, page 14)
I wish to apply for student housing: Yes No
Please note we cannot guarantee accommodation for all students.
SECTION K FINANCIAL ASSISTANCE
Please tick the appropriate box to indicate your intention to apply for student financial assistance. (See 2019 Directions for Undergraduate
Applicants, page 15)
I intend to apply for UCT/NSFAS financial assistance: Yes No
NOTE: All UCT financial assistance and NSFAS applications for funding is managed by NSFAS. Apply directly to NSFAS at www.nsfas.org.za
and submit all the supporting documents to enable the easy processing of your application. The closing date for financial assistance will be
available on the NSFAS website.If you are at school, applying for admission to the MBChB programme,
and you wish to submit the Personal Report, detach this page, which must be submitted separately
SECTION L PERSONAL REPORT FOR MBChB APPLICANTS
• Do not write in the grey areas.
• All school-leaving MBChB applicants (and those on a gap year in 2018) are invited to submit Personal Reports (PR). Applicants who have done
tertiary study are invited to submit a CV (Section M).
• If you choose not to submit a PR, you will compete with applicants who do submit a PR. The maximum score that will be awarded for the PR is 100
points but if you do not submit the PR, you will be awarded zero points.
• If you do not supply evidence required for activities outside of your school you will not get points for those activities. Only original signed letters
are acceptable.
• Complete the form, ask your principal to complete and sign section 8, then post original by 1 OCTOBER 2018 to:
The Undergraduate Admissions Office, Faculty of Health Sciences, University of Cape Town, Anzio Road, Observatory, 7925.
1. BIOGRAPHICAL DATA
First name/s:
Surname:
Applicant number or SA identity number or passport number:
Physical home address: Province
Dialling code: Telephone number:
Postal/zip code: Dialling code: Cell/mobile number:
Tick if your home address is in one of these: City/metro Town Urban township Rural village/farm
2. SCHOOL DATA
a) Name of school where secondary schooling was/is being completed: City/town, province & postal code of high school:
b) Did your last high school offer these Sports Science Computer Clubs and
facilities? (tick block) Library
fields laboratory/ies facilities societies
3. LEADERSHIP POSITION/S (ONLY WHILE AT HIGH SCHOOL) Please tick where appropriate
Please note: One can show leadership qualities in many ways, formally and informally. If your school did not offer the positions below please feel free to elaborate in section k).
If your school principal is unable to verify your entry, please supply a letter from a person of authority in your community who would be able to verify your entry.
Grade Grade Grade Comment briefly (if you wish) e.g. if more than one team / organisation under e) and f) City/town, province &
10 11 12 postal code of primary school:
a) Head girl/boy
b) Deputy head girl/boy
c) School Prefect/Student Council
d) Hostel prefect
e) Captain of sports team/s
f) Vice-Captain of sports team/s
g) Editor of a school newspaper
h) Head of debating club
i) Mentor of fellow students
j) Class representative
k) List other leadership positions
inside or outside of schoolSECTION L Continued
4. COMMUNITY SERVICE/VOLUNTARY WORK DURING HIGH SCHOOL YEARS (in and outside of school)
Notes: (1) Attach ORIGINAL SIGNED letters confirming involvement for activities outside of your school. You will not be given marks for
activities outside of your school if you do not submit evidence of such involvement.
(2) Please do not use ACRONYMS, write out the names of organisations and describe what you did while you were a member.
Weekly (W) or Did your school organise Have you attached proof
Monthly (M) or this (S)or is this an activity of your involvement in
Organisation Grade 10 Grade 11 Grade 12 Irregularly (I) or outside of your school which activities outside school?
Once-off (O)? you started on your own? (YES or NO)
a) Give details of any OTHER contribution you may
have made to your school or community during
your high school years, and indicate when you
took part in this activity.
5. CULTURAL ACTIVITIES, CLUBS, SOCIETIES ETC DURING HIGH SCHOOL YEARS (in or outside school)
E.g. Church school or other choir; musical instrument, debating society. Attach original signed letter of proof for each activity outside your school.
Weekly (W) or Is this activity offered Have you attached proof of
Monthly (M) or by your school (S) or an your involvement in activities
Activity Grade 10 Grade 11 Grade 12 Irregularly (I) or organisation outside of outside school?
Once-off (O)? your school (OS)? (YES or NO)
6. SPORTING ACTIVITIES INSIDE OR OUTSIDE SCHOOL, DURING YOUR HIGH SCHOOL YEARS
(Attach proof of club/provincial/national level activities outside of school)
List up to 3 sports in which you
participated regularly while at high school Have you attached
proof of your
In which grade/s (tick): 10: 11: 12: 10: 11: 12: 10: 11: 12: involvement in
activities outside
At which level did you participate? school?
(YES or NO)
(i) Social (outside school)
(ii) Club (outside school)
(iii) School
(iv) Provincial or National
Describe any exceptional achievement
7. WHAT OTHER ACTIVITIES OR ACHIEVEMENTS DURING YOUR HIGH SCHOOL YEARS OR AFTER GRADE 12 DO YOU WISH TO HIGHLIGHT THAT
YOU FEEL TAUGHT YOU LIFE SKILLS OR ARE RELEVANT TO YOUR APPLICATION?
For how long did you take part in this activity? Attach ORIGINAL, SIGNED proof from organisation or a letter from a person of authority who is not
family if this is not a school activity, such as a church leader.
Please note: One can learn life skills in many situations. For example, taking care of an ailing parent or grandparent or of siblings, working as a
waiter or waitress. Please feel free to enter any activity that you think taught you life skills, inside or outside of school.
8. VERIFICATION BY SCHOOL PRINCIPAL OR HIS/HER DELEGATE OF ACCURACY OF SCHOOL ACTIVITIES LISTED IN SECTIONS 2 TO 7
Name Please sign to show that you are able to verify all school activities
Position (e.g. principal) SCHOOL STAMP
Telephone number
SignatureIf you are applying for admission to the MBChB programme and have attempted tertiary studies,
you may wish to submit a CV. Detach this section and submit it separately.
SECTION M CURRICULUM VITAE FOR ALL MBChB APPLICANTS WHO HAVE ATTEMPTED TERTIARY STUDIES
• All MBChB applicants who have studied at tertiary level are invited to submit a CV.
• The CV is used to distinguish between applicants with similar academic records.
• Please supply supporting documentation and/or contact details of persons in positions of authority who are in a position to verify
information in your CV.
1. BIOGRAPHICAL DATA
First name/s:
Surname:
Applicant number or SA identity number or passport number:
Physical home address: Province:
Dialling code: Telephone number:
Dialling code: Cell/mobile number:
Postal/zip Code:
Tick if your home address is in one of these: City/metro Town Urban township Rural village/farm
2. SCHOOL DATA
a) Name of last primary school attended: City/town, province & postal code of primary school:
b) Name of last high school attended: City/town, province & postal code of high school:
c) Did your last high school offer these Sports Science Computer Clubs and
facilities? (tick block) Library
fields laboratory/ies facilities societies
In a CV of not more than 300 words, give an account of your extra-curricular activities at and since leaving school. We would be interested in
leadership positions, all forms of community engagement, team or individual sporting activities, cultural activities, special achievement and other
interests/hobbies. Please supply supporting documentation where possible, and the contact details of persons in positions of authority (who are not
related to you) who are able to verify information in your CV. Submit:
(a) this form
(b) your CV
(c) all supporting documentation
To: The Undergraduate Admissions Office
Faculty of Health Sciences
University of Cape Town
Anzio Road
Observatory
7925
By no later than 1 October 2018.SECTION M CURRICULUM VITAE
Bachelor of Arts (Fine Art) applicants:
You must detach and return the completed form with your portfolio
FOR OFFICE USE
Applicant Number:
• Refer to page 7 of 2019 Directions for Undergraduate Applicants for portfolio requirements.
• Please supply all the details requested, as the information will assist your application.
• This form must be submitted with your portfolio. The preferred date for Portfolio submissions is 31 August 2018. The final date for
submission is 1 October 2018.
• We reserve the right not to evaluate an incorrect or incomplete portfolio.
• Return to: The Secretary
The Michaelis School of Fine Art
Hiddingh Campus
31-37 Orange Street
Gardens
8001, Cape Town
SECTION N FOR BACHELOR OF ARTS IN FINE ART APPLICANTS
1. BIOGRAPHICAL DATA
First name/s:
Surname:
Home (street) address: Dialling code: Cell/mobile number:
Dialling code: Telephone number:
Postal/zip code:
E-mail address:
Date of birth: D D M M Y Y Y Y
If you need assistance because of a disability, please indicate YES NO
Disability Unit contact details. Email: dsa-disabilityservice@uct.ac.za Telephone: (021) 650 2427
HIGH SCHOOL
Enter the secondary school where you completed/are completing your secondary schooling. Please attach your latest school report to this form.
Year of Degree/diploma for Qualification
School name: School code: (Table B) registration which registered completed
POST SCHOOL
If you are not at school this year please complete the following section:
Will you qualify for eligibility to do degree studies
Year finished school: Y Y Y Y YES NO
(or have you previously qualified to do so)?)
Give detailed information of what you have done since leaving school on a separate sheet.SECTION N FOR BACHELOR OF ARTS IN FINE ART APPLICANTS (continued)
STATEMENT
Write a motivation (250-500 words) detailing why you want to study Fine Art, and indicate your future goals.
DECLARATION OF AUTHENTICITY OF WORK
The portfolio submitted with this form is my own work:
D D M M Y Y Y Y
Signature of Applicant:Bachelor of Architectural Studies applicants
You must complete, detach and return this form with your portfolio.
• Refer to page 6 of 2019 Directions for Undergraduate Applicants for portfolio requirements.
• Please supply all the details requested, as the information will assist your application.
• This form must be submitted with your portfolio. The preferred date for Portfolio submissions is 31 July 2018. The final closing date for portfolio
submissions is 1 October 2018. We reserve the right not to evaluate an incorrect or incomplete portfolio.
• Return to: The Administrator
The School of Architecture
University of Cape Town FOR OFFICE USE
Private Bag X3 Applicant Number:
7701, Rondebosch
SECTION O FOR BACHELOR OF ARCHITECTURAL STUDIES (BAS) APPLICANTS
First name/s:
Surname:
Have you had formal art lessons (either at school or privately)? YES NO
Describe these:
Have you had Design and Technology lessons at school? YES NO
Describe these:
POST SCHOOL
If you are NOT at school this year please complete the following section:
Is this the first time you have applied for the BAS degree at UCT? YES NO
Have you done a course in Architecture or Built Environment Studies at another institution? YES NO
If YES, describe the course and state the level which you have achieved:
State (year by year) what you have done since leaving school (if necessary use a separate page):
EDUCATIONAL OBJECTIVES
Are you interested in pursuing a career in: (please tick areas of interest)
1. Landscape architecture 2. City and regional planning 3. Urban design 4. Architecture
State (year by year) what you have done since leaving school (if necessary use a separate page):SECTION P DECLARATIONS BY APPLICANT AND PARENT/GUARDIAN
Without prejudice to the terms of my application for admission, I make the following declarations:
1. I will abide by the University’s rules.
2. I hold myself responsible for: the payment of all fees and charges due and payable by me to UCT each year; any arrears and interest on arrears
as defined in this year’s fee booklet; and any costs of recovery, including attorney-and-client scale fees and/or collection commission. If I do
not inform the Registrar in writing of withdrawal from studies or a course by the prescribed date(s) I will be liable for full fees even if I do not
make use of UCT facilities.
3. I accept, agree and understand that: UCT may keep and process data and documents in electronic format, including the personal data
supplied by me in my application form and in this registration form, and my image and fingerprints (both to be used solely for identification
purposes); UCT may use and transfer such data and use such documents in electronic or other formats for UCT purposes consistent with
UCT’s relationship with me as a student and former student including submission of data for the National Learners’ Record Database and
other returns as required by the Department of Higher Education and Training; that UCT places records of qualifications awarded in the
public domain; that UCT may process my personal information in accordance with its rules and policies for academic and administrative
purposes, including disciplinary processes and that UCT may use electronically generated documents in place of the originals signed by me.
4. I waive all claims against UCT for: any damage or loss suffered while I am, or as a consequence of my being, a UCT student and/or arising out
of loss or destruction of, or damage to, any property belonging to me or any other person.
5. I have not been expelled, rusticated, or excluded from any other University.
6. If I am a minor, I have the consent of my parent(s)/guardian to sign this form.
7. The information given on this form is complete and accurate. If I fail to disclose or falsely declare information (for example, non-disclosure of
previous tertiary studies), this could lead to disciplinary action and/or the cancellation of my application and/or registration at UCT.
Signature of applicant: ..................................................................................... Date : D D M M Y Y Y Y
DECLARATION AND SURETYSHIP BY PARENT OR LEGAL GUARDIAN
If you are under 18, your parent/legal guardian must make this declaration. If you are 18 or older and your parent/legal guardian will be
paying your fees, your parent/legal guardian must make this declaration.
Details of parent/guardian. (PLEASE PRINT)
Title (Table H): Surname of parent/guardian:
First names of parent/guardian:
Postal address: Country tel code: Cell/mobile number:
Identity/passport number of parent/guardian:
Postal/zip code:
I agree and consent to the above declaration, undertakings, waiver and indemnity by the applicant. I consent to the applicant signing
registration forms if admitted. I hold myself jointly and severally liable with the applicant as co-debtor for all amounts due by the applicant
to the University, until I notify the University to the contrary, in which event such cancellation shall take effect only from the beginning of
the following academic year. I consent to the University holding and processing personal information supplied by me in this application
(including any application for financial aid) for purposes related to this application.
Signature of parent/legal guardian: ........................................................................... Date: D D M M Y Y Y Y
* NOTE: An applicant under the age of 18 must have this form signed by either of his/her parents. Where an applicant has no parents (e.g. they
are deceased) or the parents are divorced, a legal guardian is normally officially appointed. In such cases the legal guardian must sign this form.
If you do not have a parent or legal guardian, a responsible adult family member (next-of-kin) or other responsible adult who is prepared to make
the declaration and the undertaking, must sign with you.The details of this person must be listed under the parent/guardian section on this form.
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