Online Application

Registration for Grade *
Growing year on year until grade 7Pre-R (Age 4-5)Grade RGrade 1Grade 2Grade 3 (available 2021)
Year of Registration *
Surname *
Full First Name *
Date of Birth *
Gender *
MaleFemale
ID Number *

State any important illness which the Applicant has suffered / suffers (e.g. Asthma, Allergies etc)
Immunizations: *
Has your child had all his / her compulsory immunizations?YesNo
Any other relevant information

Name of School *
Address of School *
Contact number of school *
To Grade
From Grade
Has the applicant ever required remedial intervention: Occupational Therapy, Physiotherapy, Psychological Assessment or any other therapy? *
We reserve the right to cancel your child's admission to Grassroots Preparatory for non-disclosure of the above information and/or documents.YesNo
If Yes, Please supply details:

Full Name and Surname of Father *
ID Number *
Career *
Email Address *
Residential Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Tel No. (W)
(H)
(Mobile) *
Full Name and Surname of Mother *
ID Number *
Career *
Email Address *
Residential Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Tel No. (W)
(H)
(Mobile) *
Marital Status *
MarriedDivorcedWidowed
Preferred contact for general communication from school *
MotherFatherBoth
Preferred contact for school accounts *
MotherFatherBoth
Where did you hear about us *
FaceBookInstagramWhatsAppGoogle SearchRadio AdvertismentsAdvertising through local school networkWord of MouthOther
If "other" was ticked above, please elaborate

Copy of applicant's birth certificate *
YesNo
File Upload - Pdf, Jpeg, Png
Copy of applicant's clinic card *
YesNo
File Upload - Pdf, Jpeg, Png
Copy of applicant's last report *
YesNo
File Upload - Pdf, Jpeg, Png
Copy of assessments (if applicable) *
YesNo
File Upload - Pdf, Jpeg, Png
Copy of Father's ID *
YesNo
File Upload - Pdf, Jpeg, Png
Copy of mother's ID *
YesNo
File Upload - Pdf, Jpeg, Png
Proof of address *
Not older than 3 monthsYesNo
File Upload - Pdf, Jpeg, Png
Proof of payment of the non-refundable administration fee of R370 *
YesNo
File Upload - Pdf, Jpeg, Png
On receipt of this form the applicant's name will be placed on file. Acceptance of this application does not imply final acceptance of applicant. Scheduled interviews with parents and learners form part of the application process.

Religious Instruction *
Grassoots Prep is a Christian based school and religious instruction forms part of the school morning. All other religions are respected.I accept
*
I understand that this application will only be processed once the application form is returned to the school with ALL the relevant documentation attached.I accept
Date of Application submission *
PROMO CODE (Where applicable)

Bank Details (Please use your child's name and surname as a reference) ACCOUNT NAME: The Grassroots Preparatory BANK: Standard Bank ACCOUNT NUMBER: 271 799 145 BRANCH: Kenilworth Centre BRANCH CODE (ELECTRONIC PAYMENTS): 051001 BRANCH CODE: 026209 ACCOUNT TYPE: Current Account
*
Upon Acceptance, a non-refundable admission fee of R3650 must be paid to secure your child's place at the school.I accept