WESTERFORD HIGH SCHOOL • 220 Main Road, Rondebosch, 7700
Tel: (021) 689-9154 • Fax: (021) 685-5675 • E-mail: firstname.lastname@example.org
Please ensure that ALL details given are correct, especially the contact details. You will receive an automated copy of the responses to the below email address.
SECTION 1: LEARNERS INFORMATION
Citizenship*South AfricanSouth African (Permanent Resident)AmericanCanadianCongoleseFilipinoGermanGreekIndianIrishItalianNetherlandsNorwegianNigerianPakistanRwandanSouth KoreanUK CitizenUSAZimbabweanOther
Home Language*AfrikaansDutchEnglishEnglish & AfrikaansFinnishFrenchGermanGreekHebrewisiXhosaItalianKinyaRwandaKoreanMandarinNdebelePediPolishPortuguesePunjabiRomanianRussianShonaSothoSpanishSwahiliTsongaTswanaVendaVietnameseXhosaZuluOther
Has the learner had any professional support at the present school during the last five years?YesNo
Please indicate who has provided the support
Social WorkerEducational PsycologistSpeech TherapistPhsycologistOccupational TherapistPsychiatrist
Are there any siblings (brothers or sisters) at WesterfordYesNo
Who does the learner reside with?MotherFatherBothJoint CustodyOther
SECTION 2: PARENT / GUARDIAN 1 DETAILS
• Please note that certain information here may be the same as in both section 1 and 3 • We use the terms "Parent 1" and "Parent 2" in the following sections. "Parent 1" is regarded as the Primary contact person.
Is there a second parent/guardian to complete their portion of the form?*YesNo
SECTION 3: PARENT / GUARDIAN 2 DETAILS
SECTION 4: GETTING TO KNOW YOUR CHILD
• This section of the form must be completed by the pupil applicant in his or her own words.
CLUBS AND SOCIETIES
SPECIAL ACHIEVEMENTS AND INTERESTS
After submitting this form, you will be emailed an automated copy. This does NOT need to be printed out and handed in at our reception. Please remember to upload a photograph before submitting.
PLEASE UPLOAD A PORTRAIT PICTURE OF THE STUDENT HERE: MAX UPLOAD FILE SIZE - 10MB
Don’t forget to follow us on Social Media!
Telephone: 021 689 9154 • Email: email@example.com
Address: 220 Main Road, Rondebosch, Cape Town, 7700