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Online Application
Details of Learner
Registration for Grade
*
Growing year on year until grade 7
Pre-R (Age 4-5)
Grade R
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5 (available 2023)
Year of Registration
*
2020
2021
2022
2023
2024
2025
Surname
*
Full First Name
*
Date of Birth
*
Gender
*
Male
Female
ID Number
*
Medical History
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?
Yes
No
Any other relevant information
Name and address of previous school attended by applicant (if applicable)
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.
Yes
No
If Yes, Please supply details:
Details of Parents / Guardians
Full Name and Surname of Father
*
ID Number
*
Career
*
Email Address
*
Residential Address
*
Street Address
Apt, Suite, Bldg. (optional)
City
State / Province / Region
Postal / Zip Code
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo (Brazzaville)
Congo
Costa Rica
Cote d\'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor (Timor Timur)
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia, The
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, North
Korea, South
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palestinian Territory
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Western Sahara
Western Samoa
Yemen
Zambia
Zimbabwe
Country
Tel No. (W)
(H)
(Mobile)
*
Full Name and Surname of Mother
*
ID Number
*
Career
*
Email Address
*
Residential Address
*
Street Address
Apt, Suite, Bldg. (optional)
City
State / Province / Region
Postal / Zip Code
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo (Brazzaville)
Congo
Costa Rica
Cote d\'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor (Timor Timur)
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia, The
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, North
Korea, South
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palestinian Territory
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Western Sahara
Western Samoa
Yemen
Zambia
Zimbabwe
Country
Tel No. (W)
(H)
(Mobile)
*
Marital Status
*
Married
Divorced
Widowed
Preferred contact for general communication from school
*
Mother
Father
Both
Preferred contact for school accounts
*
Mother
Father
Both
Where did you hear about us
*
FaceBook
Instagram
WhatsApp
Google Search
Radio Advertisments
Advertising through local school network
Word of Mouth
Other
If "other" was ticked above, please elaborate
The Following Must Accompany This Application
Copy of applicant's birth certificate
*
Yes
No
File Upload - Pdf, Jpeg, Png
Copy of applicant's clinic card
*
Yes
No
File Upload - Pdf, Jpeg, Png
Copy of applicant's last report
*
Yes
No
File Upload - Pdf, Jpeg, Png
Copy of assessments (if applicable)
*
Yes
No
File Upload - Pdf, Jpeg, Png
Copy of Father's ID
*
Yes
No
File Upload - Pdf, Jpeg, Png
Copy of mother's ID
*
Yes
No
File Upload - Pdf, Jpeg, Png
Proof of address
*
Not older than 3 months
Yes
No
File Upload - Pdf, Jpeg, Png
Proof of payment of the non-refundable administration fee of R370
*
Yes
No
File Upload - Pdf, Jpeg, Png
Please indicate if after school care will be required
*
If yes, please contact the school for after school care registration forms.
Yes
No
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.
Declaration Agreement
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
*
Banking Details
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
*
If you are applying during 2022, then upon Acceptance, a non-refundable admission fee of R4 280 along with January 2023 fees must be paid to secure your child's place at the school. Should you decide NOT to join Grassroots in January 2023 then your first months fees (January 2023) becomes non-refundable.
I accept
Verification
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*
Example: 56
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:
Our Vision, Mission, and Values
▼
The Symbolic Meaning of our Name – Grassroots
Our Education Philosophy
The Constitutional Basis For Quality Education
Our Code Of Conduct
Curriculum
Media
▼
Gallery
Video
Fees
Online Application
Contact Us