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LEARNER'S PERSONAL DETAILS
First Name
Last Name
Second Name
Learner's Initials
Date of birth
Gender
Grade Applying For
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Current Grade
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Years in this grade
ID / Passport / Permit No
Permit Expiry Date
Race
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Home Language
Population Group
Citizenship
Does the learner have siblings at learnmore?
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Physical Address
Name of previous school
Phone number of previous school
Last date of attendance
Does the learner have a deceased parent?
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Child's Birth Certificate
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Certified Immunization Card
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Latest Report
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Transfer Letter
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Parent 1/ Guardian 1
Title
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Last Name
First Name
ID Number
Phone Number
Email Address
Marital Status
Relationship to learner
Emergency Phone Number
Work Contact Number
Residential address*
Country
Parent 2/ Guardian 2
Title
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Last Name
First Name
ID Number
Phone Number
Email Address
Marital Status
Relationship to learner
Emergency Phone Number
Work Contact Number
Residential address*
Country
MEDICAL INFORMATION
Name of medical Aid
Medical aid number
Main member's Initial & Surname
Allergies / Medical Problems
Doctor's information
Doctor's name
Doctor's Phone Number
Next of kin
Title
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Last Name
Relationship to learner
Residential address*
Country
First Name
ID Number/ Passport
Phone Number
Work address*
Country
Contact No Tel (work)
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