Admission Form

Surname of pupil *

First names *

Preferred name (not nickname) *

ID Number or Passport Number (if over-border) *

Date of birth *

Place and country of birth *

Home language *

That is, language most frequently used at home. If relevant, state more than one language, e.g. English/Afrikaans or Xhosa/English.

Year and term when admission is desired *

and Grade to be entered *

Is the pupil to be a boarder or day scholar? *

Boarder
Day Scholar

Name, address and phone number of present school

Name of present school *

Address of present school

Address Line 1

City

State / Province / Region

Postal Code

Country

Phone number of present school *

Pupil’s present Grade *

Date of admission to present school: *

month and year

Names of all previous schools attended:

School 1

Grade/ Form

Previous school 1: Grade/Form

Year

Previous school 1: Year

School

Previous school 1: School

Town/City

Previous school 1: Town/City

Country

Previous school 1: Country

School 2

Grade/Form

Previous school 2: Grade/Form

Year

Previous school 2: Year

School

Previous school 2: School

Town/City

Previous school 2: Town/City

Country

Previous school 2: Country

School 3

Grade/Form

Previous school 3: Grade/Form

Year

Previous school 3: Year

School

Previous school 3: School

Town/City

Previous school 3: Town/City

Country

Previous school 3: Country

School 4

Grade/Form

Previous school 4: Grade/Form

Year

Previous school 4: Year

School

Previous school 4: School

Town/City

Previous school 4: Town/City

Country

Previous school 4: Country

Grades repeated *

Family Background

Religious denomination

Do you have any association with St Andrew’s College, Prep or Diocesan School for Girls *

If an Old Girl of DSG or there is/was a sister at DSG, please give maiden name, dates and House:

Name #1

#1 Old Girl of DSG: Name #1

Dates #1

#1 Old Girl of DSG: Dates #1

House #1

#1 Old Girl of DSG: House #1

Name #2

#2 Old Girl of DSG: Name #2

Dates #2

#2 Old Girl of DSG: Dates #2

House #2

#2 Old Girl of DSG: House #2

Name #3

#3 Old Girl of DSG: Name #3

Dates #3

#3 Old Girl of DSG: Dates #3

House #3

#3 Old Girl of DSG: House #3

Name #4

#4 Old Girl of DSG: Name #4

Dates #4

#4 Old Girl of DSG: Dates #4

House #4

#4 Old Girl of DSG: House #4

If an Old Andrean or there is/was a brother at College/Prep, please give name, dates and House:

Name #1

#1 Old Preppie/Andrean: Name #1

Dates #1

#1 Old Preppie/Andrean: Dates #1

House #1

#1 Old Preppie/Andrean: House #1

Name #2

#2 Old Preppie/Andrean: Name #2

Dates #2

#2 Old Preppie/Andrean: Dates #2

House #2

#2 Old Preppie/Andrean: House #2

Name #3

#3 Old Preppie/Andrean: Name #3

Dates #3

#3 Old Preppie/Andrean: Dates #3

House #3

#3 Old Preppie/Andrean: House #3

Name #4

#4 Old Preppie/Andrean: Name #4

Dates #4

#4 Old Preppie/Andrean: Dates #4

House #4

#4 Old Preppie/Andrean: House #4

Other

If other than Old Andrean, Brother at College/Prep, Old Girl of DSG or Sister at DSG:

Sisters

Name

#1 Sister: Name

Age

#1 Sister: Age

Present school

#1 Sister: Present school

Name

#2 Sister: Name

Age

#2 Sister: Age

Present school

#2 Sister: Present school

Name

#3 Sister: Name

Age

#3 Sister: Age

Present school

#3 Sister: Present school

Brothers

Name

#1 Brother: Name

Age

#1 Brother: Age

Present school

#1 Brother: Present school

Name

#2 Brother: Name

Age

#2 Brother: Age

Present school

#2 Brother: Present school

Name

#3 Brother: Name

Age

#3 Brother: Age

Present school

#3 Brother: Present school

Is there any additional information you would like to be brought to the attention of the Head?

Please outline below

Is there any additional information you would like to be brought to the attention of the Head?

Parent or Legal Guardian Information

Father's information *

Applicable
Not applicable

Father's title & initials *

(Prof/Dr/Mr)

Father's surname *

Father's first name *

Father's preferred name *

Father's date of birth *

Father's employer *

Father's position held *

Father's sector *

Father's marital status (in relation to this Pupil) *

Father's ID No./ Passport No. *

(Passport no. for non-South Africans)

Father's citizenship *

Father's residential address

Address Line 1

City

State / Province / Region

Postal Code

Country

Father's postal address

Address Line 1

City

State / Province / Region

Postal Code

Country

(for reports and correspondence other than email)

Father's home telephone *

Father's business telephone *

Father's cell *

Father's email *

*Please note that you are obliged to notify us promptly of any changes of contact details

Parent or Legal Guardian Information

Mother's information *

Applicable
Not applicable

Mother's title & initials *

(Prof/Dr/Mr/Mrs/Ms)

Mother's surname *

Mother's first name *

Mother's preferred name *

Mother's date of birth *

Mother's employer *

Mother's position held *

Mother's sector *

Mother's marital status (in relation to this pupil) *

Mother's ID No./ Passport No. *

(Passport no. for non-South Africans)

Mother's citizenship *

Mother's residential address

Address Line 1

City

State / Province / Region

Postal Code

Country

Mother's postal address

Address Line 1

City

State / Province / Region

Postal Code

Country

(for reports and correspondence other than email)

Mother's home telephone *

Mother's business telephone *

Mother's cell *

Mother's email *

*Please note that you are obliged to notify us promptly of any changes of contact details

Parent or Legal Guardian Information

Guardian's information *

Applicable
Not applicable

Guardian's title & initials *

(Prof/Dr/Mr/Mrs/Ms)

Guardian's surname *

Guardian's first name *

Guardian's preferred name *

Guardian's date of birth *

Guardian's employer *

Guardian's position held *

Guardian's sector *

Guardian's marital status (in relation to this pupil) *

Guardian's ID No./ Passport No. *

(Passport no. for non-South Africans)

Guardian's citizenship *

Guardian's residential address

Address Line 1

City

State / Province / Region

Postal Code

Country

Guardian's postal address

Address Line 1

City

State / Province / Region

Postal Code

Country

(for reports and correspondence other than email)

Guardian's home telephone *

Guardian's business telephone *

Guardian's cell *

Guardian's email *

*Please note that you are obliged to notify us promptly of any changes of contact details

Address to which the account should be emailed: Father/ Mother/ other: *

House Preference No undertaking can be given that a pupil will be placed in any particular House.
Write 1 against first preference, 2 against second preference and 3 against third preference

Crewe

Espin

Knowling

Merriman

No preference

Give reasons for choices

The following documents must please accompany this application:

A copy of the last two reports from the Pupil’s present school if the application is for this year or next year.

A copy of the last two reports from the Pupil’s present school if the application is for this year or next year.