Building Blocks Pre-Primary & Nursery School - Curro
←
→
Page content transcription
If your browser does not render page correctly, please read the page content below
Building Blocks
Pre-Primary & Nursery
School
“forming foundations for healthy Adults”
Founded 2000
Application for
Admission
48 Harry Galaun Road, Halfway House, Midrand. P.O. Box 12811, Vorna Valley, 1686.
Tel: 087 232 1383. Fax: 086 637 4597. E-mail: accounts@building-blocks.co.za
San Ridge Pre-Primary Vorna Valley Pre-Primary Noordwyk Pre-Primary
(011) 318-0996 (011) 312-1397 (011) 318-5256Building Blocks Pre-Primary
& Nursery School LEARNER
“forming foundations for healthy Adults” PHOTO
Founded 2000
Application for Admission
PLEASE NOTE: The following documents must accompany the Application Form.
2 Passport size photos of the Learner
A copy of the Learner’s birth certificate
A copy of the Learner’s clinic card
A copy of the Learner’s latest school report
A copy of both parent’s ID documents / Passports
A copy of Study Permit if not SA Resident
Proof of residence (Municipal rates account)
Copy of Medical Aid Card
Completed Application Form signed by both parents
Completed Debit Order Form signed by both parents
Completed My School Application
Completed Makro Application
Payment of Non Refundable Application Fee of R1100-00
(This is inclusive of the R550-00 Registration Fee & the R550-00 Annual Stationery Fee)
NB: No application will be processed without proof of payment of the Non Refundable
Application Fee and all above required documents attached.
FOR OFFICE USE VV SR NW
NON-REFUNDABLE DATE: RECEIPT
APPLICATION FEE PAID NO:
ACCEPTED CREDIT CHECK
YES NO YES NO
ENROLLMENT FEE STRUCTURE FULL HALF
DATE DAY DAY
CLASS TEACHER
PASTEL ACC. NO. SIBLINGS AT YES NO
SCHOOL
FEES DEBIT TSP DEBIT
ORDER NO. ORDER NO.
COMMUNICATOR CHEVRON ISSUED BAG & BOTTLE UNIFORM ISSUED
ISSUEDPART 1: Section A: Particulars of Learner
Surname
Full Names
Preferred Name
Male Female
Position in family Date of Birth
(eg: first born) (dd/mm/yy)
Identity Number or Passport Number
Nationality South African Other:
Home Language Religion
PART 1: Section B: Current School Information of Learner
Current School Current Grade
Headmaster/mistress School Telephone No.
Current Teacher Reason for Leaving
PART 1: Section C: Siblings attending Building Blocks Schools
Name & Surname
Date of Birth Currently attending
which Building Blocks
Name & Surname
Date of Birth Currently attending
which Building Blocks
PART 1: Section D: Social & Emotional Development of Learner
In a few words describe your Learner’s general
disposition, their fears, their dislikes and general
ability to mix with other Learner’s. Please also
describe their strengths.
PART 1: Section E: Learner Support
Has your Learner received learning support
YES NO
(Speech or Occupational Therapy)
All relevant reports to be attached.
YES NO
Are these reports attached?
Initial: __________ __________
Mother FatherPART 2: Section A: Learner’s Medical History
Please note this is a very important part of your application. We cannot be held responsible for any incidents that may occur
due to incorrect information given. A doctor’s certificate is to accompany any life threatening allergies or medical condition.
Delivery Normal Ceasar
Is this your first baby? No Yes
Any miscarriages? No Yes
If Yes, Reason why?
Any problems while pregnant? No Yes
If Yes, What?
Full Term Pregnancy? Yes No Was baby Premature? Yes No
If premature, Why?
Baby’s birth weight? Discharge weight?
Apgar Test /10 2nd Apgar Test /10
SIDS in family Father’s side Yes No Mothers’ side Yes No
SMOKERS in family Father’s side Yes No Mothers’ side Yes No
EPILEPSY in family Father’s side Yes No Mothers’ side Yes No
DIABETES in family Father’s side Yes No Mothers’ side Yes No
History of Convulsions Father’s side Yes No Mothers’ side Yes No
Are Inoculations up to date? No Yes
Has the Learner ever suffered a HEAD INJURY No Yes
If Yes, Date & Details of event?
Has the Learner had:
Chicken Pox No Yes Mumps No Yes
Measles No Yes Meningitis No Yes
Has the Learner ever been HOSPITALIZED No Yes
If Yes, Date & for what?
Learner suffered from RESPIRATORY No Yes
DISORDER
If Yes, Details?
Has the Learner had:
Asthma No Yes Croup No Yes
Bronchitis No Yes Pneumonia No Yes
Does the Learner use an INHALER No Yes
If Yes, Name & Dose?
Does the Learner take CHRONIC No Yes
MEDICATION
If Yes, Name & Dose?
Has the Learner suffered a FEBRILE No Yes
CONVULSIONS?
If Yes, When, reason for convulsion & was an
EEG conducted.
Does the Learner suffered from NOSE BLEEDS No Yes
If Yes, Details?
Does the Learner suffered from HEADACHES No Yes
If Yes, Details?
Initial: __________ __________
Mother FatherPART 2: Section B: Learner’s Allergy History
Has your Learner suffer from any ALLERGIES No Yes
If Yes, Allergic to what,
& explain reaction & Medication to be taken.
Dairy No Yes Nuts No Yes Fish No Yes
Soya No Yes Eggs No Yes Wheat No Yes
Grass No Yes Pollen No Yes Bee’s No Yes
PART 2: Section C: Medical Aid Details
Medical Aid Name Medical Aid Number
Name of Primary Member
Doctors Name Doctors Telephone No.
PART 2: Section C: Policy Regarding Sick Learners
THESE RULES ARE NOT NEGOTIABLE.
Parents are required to assist us in preventing cross infection of the Learner’s and therefore we have implemented these rules.
1. Learner’s with eye infections are not permitted at school and require a doctor’s clearance certificate upon return to
school.
2. Learner’s with runny tummies or vomiting are not permitted at school and require a doctor’s clearance certificate
upon return to school.
3. Should a Learner have Lice or Ring Worm they will not be permitted back at school until they have a doctor’s
clearance certificate.
4. Should a Learner be prescribed Anti-Biotic, your Learner will not be permitted back at the school for the first 48hrs
and we will require a doctor’s clearance certificate upon return to school.
5. Should a Learner be sent home due to illness we will require a doctor’s clearance certificate upon return to school.
6. Once we have phoned the parent to collect a Learner, the Learner is to be collected within 30 minutes by either the
parent or an authorized family member.
7. In case of emergency and we need to administer medication, we will call for authorization and the parent will need to
sign the Medicine Incident Report Book on collection.
Any medication that has to be administered must be removed from the Learner’s bag and handed to the Principal on duty.
The parents are to fill in the medication and dosage at the back of their Learner's Diary - If this is not done NO
medication will be administered. When collecting your Learner the medication will be in the office NOT in the bag. It is
your responsibility to collect your Learner's medication from the office.
Initial: __________ __________
Mother Father
PART 2: Section D: Policy Regarding an Alternative Person collection a Learner
THESE RULES ARE NOT NEGOTIABLE.
If someone else is going to collect a Learner the following procedure has to be followed.
1. The parent needs to phone the school in time with the person’s name and ID Number that will be collecting the
Learner.
2. On arrival the person needs to present their ID Document or Drivers Licence for verification. Without an ID
Document or Drivers Licence the Learner will not be released.
3. The school will not phone the parents to verify the alternative pick up.
4. Please make sure that the following rules are adhered to so that we can keep our Learner’s safe.
5. Please also note that no Domestic Workers or Outside Transport Company will be loaded on the Access Gate System.
6. Parents are to furnish the school with a copy of the Domestic Workers / Outside Transport Company’s ID Document
to go onto the Learner’s file as authorised pick-up.
7. Management will open for the Domestic Worker or Outside Transport Company daily.
Initial: __________ __________
Mother FatherPART 3: Particulars of Parent(s)
MOTHER FATHER
Responsible for Fees YES NO YES NO
Surname
First Name(s)
Preferred Name
Marital Status
Identification No.
Residential address.
Postal address.
Telephone No. Home
Cell phone No.
E-mail address
Employer Name &
Address
Position / Occupation
Telephone No. & Ext
Learner lives with
Both Parents Mother Father
Reports to:
Both Parents Mother Father
Accounts to:
Both Parents Mother Father
PART 4: Alternative Contact Particulars (Relative)
Name & Surname
Relationship to
Learner
Contact Number
Cellphone & Work
Initial: __________ __________
Mother FatherPART 5: Debit Order Instruction
I / We authorize De Jager Kids cc utilizing the services of ABSA Business Integrator, to draw against
My / our account as detailed below:
Account Holder
Bank Name
Branch Name Branch Code
Account Type Cheque Savings Transmission
Account Account Account
Account Number
Amount Due
per month R School Fees
Annual Fees to 10 months 11 months 12 months
be paid Monthly
Jan - Oct Jan – Nov Jan – Dec
Date of First Run
Month
Date of Run 15th of Month 20th of Month 25th of Month 1st of Month
(fees in ADVANCE)
Or any other bank or branch to which I may transfer my / our account, an amount as determined and agreed in my /
our Agreement with De Jager Kids cc on the dates so stated above each and every month commencing on the date
of first order above, until termination of the contract by either party in writing at least 30 (thirty) calendar days
notice, with the understanding that no refund or setoff shall be authorized which was authorized whiles the
amount(s) were legally owed.
I / We agree to pay any Bank Charges relating to this debit order instruction and also understand that each
withdrawal will be reflected on my / our bank statement and identified by a code ABSA / De Jager Kids CC.
Assignment: I / We acknowledge that the party hereby authorized to effect the drawing(s) against my/our account
may not cede or assign any of its rights to any third party without my/our prior consent and that I/We may not
delegate any of my/our obligations in terms of this contract/authority to any third party without prior written
consent of the authorized party.
Dated at ______________________ on this __________ day of ________________, 20______.
Authorized Signature Authorized Signature
PLEASE NOTE: Any changes to the above debit order is to be done in writing by the 10th of the Month in
order to make changes before the next debit order is due to commence. Failure to do this will result in you paying
any bank charges if the debit order is returned. If your debit order gets returned for ANY reason we will
automatically charge you a debit order return fee of R150-00 which needs to be settled by the 7th of that month.
Initial: __________ __________
Mother FatherPART 6: Terms and Conditions of Enrolment
I/We the undersigned _____________________________________________________________________ hereby declare
that the information given in the aforementioned Application Form is both true and correct.
1. Learner’s enrolment will be subject to the conditions stated hereunder or such other conditions which may have
been determined by the Board of Governors or their duly authorised representatives (the Board) from time to
time.
2. Applications for enrolment shall be in the form specified and shall be accompanied by a non-refundable
application fee in an amount to be determined from time to time and reflected on the application form.
3. The REGISTRATION fee, STATIONERY fee and TOILETRIES are not refundable under ANY
circumstances.
4. Building Blocks Pre-Primary & Nursery School / The Board, reserve the right to refuse admission based on the
credit scoring received from Trans Credit Bureau.
5. Building Blocks Pre-Primary & Nursery School / The Board, reserve the right to not divulge the full details as
received from Trans Credit Bureau to any applicant.
6. The parents agree to be bound by the RULES, REGULATIONS, POLICIES & PROCEDURES of the school,
as determined from time to times, and enunciated by the Board and/or the Principal.
7. Serious breach of the rules, regulations, policies and procedures may result in a Disciplinary Hearing, Suspension
or even expulsion of the Learner from Building Blocks Pre-Primary & Nursery School.
8. The Principal will act in “loco parentis” whilst the Learner attends Building Blocks Pre-Primary & Nursery
School.
9. Fees are payable in advance, before or on the first day of the month. Fees are payable, either annually or
monthly, in advance, free of exchange, deduction or set off. Non-payment shall entitle the Board to withdraw
educational services and cancel the Enrolment of the learner forthwith.
10. To give ONE CALENDAR MONTHS WRITTEN NOTICE if the Learner is going to leave the school before
or at the end of September. Notice to be handed in, in writing by the 1 st of September and last day of attendance
is the 30th of September. One month’s notice accepted for the following months; January, February, March,
April, May, June, July, August and September. No exceptions will be allowed.
11. Thereafter a THREE MONTHS WRITTEN NOTICE period is required until the end of December if the
Learner will not be returning to the school in the following Academic Year. Notice to be handed in, in writing by
the 1st of October for the last 3 months of the year. No exceptions will be allowed.
12. The school contract is an OPEN ENDED CONTRACT and you need not apply at the school every year, the
Learner will automatically move to the next grade if no WRITTEN NOTICE is received.
13. We the parents further agree that in the event of an emergency arising in terms of which the pupil will require
urgent medication, the pupil may be taken to the nearest hospital, clinic or doctor at the discretion of the Principal
or authorised senior staff member. The parents undertake to accept full responsibility for any medical costs
incurred in the event of such an emergency.
14. The parents hereby indemnify and agree to hold harmless Building Blocks Pre-Primary & Nursery School, the
Board of Governors, the Principal and Staff, or the authorised agents or representatives of the aforementioned,
against any and all claims, howsoever arising, including negligence, arising out of any injury, death, loss,
damage, cost or expense, including legal costs, suffered by the learner or a third party as a result of or during the
enrolment of the learner at the school.
15. To take full responsibility in the case of lost clothing due to the fact that it was not marked properly.
16. We understand that De Jager Kids cc, T/A Building Blocks Pre-Primary & Nursery School are registered with
Trans Union Credit Bureau, (ITC)., and agree that Building Blocks Pre-Primary & Nursery School will perform a
credit search based on our application.
17. Should we fail to honour our commitment to pay all fees to Building Blocks Pre-Primary & Nursery School,
Building Blocks Pre-Primary & Nursery School reserves the right to submit details of our non-performance with
Trans Credit Bureau and Trans Credit Bureau may share such information with other credit providers and Trans
Union Credit Bureaus customers for prescribed purposes.
18. Building Blocks Pre-Primary & Nursery School will provide you with 20 days written notice before your details
are submitted for listing in order for your account standing to be rectified.
19. We understand that this is a legal and binding contract between us and Building Blocks Pre-Primary and Nursery
school. The school shall be entitled to instruct its attorneys to attend to the collection of outstanding accounts and
the parents will be liable for the payment of all costs incurred.
20. We the parents accept the terms of “Policy regarding payment of School Fees, Late Payments and Late Collection
Fines” and “Policy for Sick Learner’s” and “Policy on Compulsory School Uniform.” And “Policy for
Alternative Authorised Pick Up”
As parents we hereby sign below as indication that we have read, understood and accept the content of the Conditions of
Enrolment as described above. We agree that our Learner’s admission is subject to the above terms and conditions.
DATED AT _______________ in this ________ day of ___________________, 20_______.
Signature of Father Signature of MotherPART 7: Policy regarding payment of School Fees, Late Payment and Late Collection Fines
1. Applications for enrolment shall be accompanied by a non-refundable application fee in an amount to be determined
from time to time and reflected on the application form.
2. The purpose of this policy is to ensure that fees due to the school are paid when they are due and to create a procedure
to deal with instances where fees are not paid.
3. CASH IS NOT A PAYMENT OPTION. Parents wanting to pay CASH will need to make a full payment of One
Month’s Fees as a Cash Deposit which will increase annually.
4. Non-South African Residents will need to make a full payment of One Month’s Fees as a Foreigner Deposit
which will increase annually.
5. Failure to pay fees on time places considerable and unnecessary burden on the school. We are placed under financial
pressure as our ability to meet our own financial obligations is compromised.
6. Fees include Tuition, Breakfast, Lunch and all Snacks & Drinks.
7. There are two fee structure: Full Day and Half Day, please indicate which one you require.
School Fee Structure FULL DAY HALF DAY
8. Fees are payable in advance, either annually or monthly.
9. Annual payments will receive a 10% discount on fees if received by the 15th of December or 5% if received by the 1st
day of January in the new Academic Year.
10. Monthly payments MUST be made via debit order either over 10months, Jan to Oct or 11months, Jan to Nov or
12months, Jan to Dec. Indicate which option you choose to conduct the payment of your School Fees
ANNUAL 10 MNTHS JAN-OCT 11 MNTHS JAN-NOV 12 MNTHS JAN-DEC
11. If your debit order gets returned for ANY reason we will automatically charge you a DEBIT ORDER RETURN
FEE of R150-00 which needs to be settled immediately or by the 7th of that month.
12. After the 1st of the month and fees are still outstanding an additional LATE PAYMENT FEE of R150-00 will be
added to your account.
13. Failure to make full payment of the outstanding fees and penalties will result in the pupil concerned being suspended
and will not be permitted to return to school until the full outstanding amount is settled.
14. Any school fees and penalties outstanding as at the 1st of December will result in the report and transfer documents
being withheld until the total outstanding has been settled, the school may also terminate the learners enrolment for
the following year.
15. On late collection of your Learner, a PENALTY FEE of R50.00 for the first 15 minutes and then R100.00 for every
15 minutes thereafter will be charged per Learner. This fine will need to be paid directly to the Manager on Duty
when the Learner is collected. Please note that this is a Penalty fee and does not form part of the School Fees.
16. This is a legal and binding contract between us, the parents, and Building Blocks Pre-Primary & Nursery School. The
school shall be entitled to instruct its attorneys to attend to the collection of outstanding accounts and the parents will
be liable for the payment of all costs incurred, on the scale as between attorney and own client, including collection
fees. In the event of action instituted the parent’s consent to the Magistrate’s Court jurisdiction.
17. We choose as our domicilium citandi et executandi for all purposes, including the giving of any notice required or
permitted hereunder and any proceedings which may be instituted by virtue hereof, at our Residential Address, E-mail
Address, and Postal Address as stated on Page 6 of the Application for Admission.
Initial: __________ __________
Mother Father
PART 8: Policy regarding Compulsory School Uniform
1. Building Blocks is a Private School and Uniform is Compulsory. Learners are to wear school uniform every day.
2. Uniform is to be in good order, neat and clean every day.
3. By enrolling our Learner at Building Blocks Pre-Primary & Nursery School we agree that this Policy will form part of
the agreement between us, the parents & the school.
4. Summer uniform is to be worn in the Summer months and Winter uniform in the Winter months.
5. If your Learner is not in the correct uniform he/she will be sent home.
6. Stock is always available from the School Uniform Shop.
Initial: __________ __________
Mother Father
PART 9: Policy regarding PEANUT FREE School
1. Building Blocks is a PEANUT FREE School.
2. No snack or food item will be allowed onto the school grounds.
3. In the event of a Birthday Party NO PARTY PACKS will be allowed.
4. For a party, parents are advised to bring in plain iced cup cakes and a few packets of Flings.
5. A Birthday cake will be permitted on condition that there is no cream or nuts.
Initial: _________ __________
Mother FatherFOR OFFICE USE ONLY! PARENTS PLEASE DO NOT FILL IN!
School V.V. N.W. S.R.
YEAR OF ADMISSION DATE OF
ADMISSION
ANNUAL PAYER YES NO DEBIT ORDER DATE 15th 20th 25th 1st
Non-South African YES NO MONTHS DEPOSIT YES NO
Resident PAID
GRADE TEACHER
Special Fees Full day one Full day family Half day one Half day family fee:
(as per Lesley) Learner: fee: Learner:
R
R R R R
R Initial Annual
DETAILS OF FIRST Administration Stationery
PAYMENT
Fee Fee
How did they pay? (Per family) (Per Learner)
Date? R 550-00 R 550-00
Admin Fee
Stationery Fee Receipt # Receipt #
Non-South African
Resident
Months Deposit
School Fees
Transport Fees Date Paid Date Paid
Total Uniform Purchase
Payment method of
Uniform Purchased
Pastel Fees Debit Transport
Acc # Order # Debit
Order #
Details of First
Invoice.
Processed
ENROLLED BY:
DATE ENROLLEMENT
RECEIVED:You can also read
