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Admission Form

Thank you for your interest in our special little school, we trust we can be of assistance to you and your family.


Below please find documentation which must be completed in full and returned to us with legible copies of the following essential reports/documents in order for an interview and assessment period to

be considered.

  • Birth certificate

  • Psychologists report

  • School reports

  • Immunisation card

  • Detailed medical report


Where applicable please include reports from:

  • Occupational Therapist

  • Physiotherapist

  • Speech Therapist


Looking forward to meeting you and your special needs child!

Date of Application

Child's Information

Medical Aid

Doctors

Infectious Diseases

MEASLES
Yes
No
MUMPS
Yes
No
RUBELLA/GERMAN MEASLES
Yes
No
WHOOPING COUGH
Yes
No
CHICKEN POX
Yes
No
RHEUMATIC FEVER
Yes
No
SCARLET FEVER
Yes
No
HIV / AIDS
Yes
No
HEPATITIS A, B, Or C
Yes
No
OTHER
Yes
No

Admissions

Please be aware below is the digital version of our admissions form, you will be required to fill out, and submit at the end of every page (6 Pages in total). Alternatively you may download our form using the button below, print it out, fill it out, scan the document, and upload it back to the site.

​

You can view our policies such as Terms & Conditions here,

our Privacy Policy here, and our Accessibility Statement here.

Admission Form 2

Immunisations

Hepatitis B
Yes
No

Current Medication

Previous Medication

Birth History

Milestones

Admissions Form 3

Child's Ability

Other

School Attended

Unsuccessful Admission

Emergency Contact

Next of Kin

Admission Form 4

Father's Details

Custodial Parent
Yes
No

Telephone Numbers

Email

Fax Number

Work

Income
Below R 7,000
Above R 7,000
Above R 20,000
Additional Income
Child Care Grant
Disability Grant
Other

Admissions Form 5

Mother's Details

Custodial Parent
Yes
No

Telephone Numbers

Emails

Fax Number

Occupation

Single choice
Below R 7,000
Above R 7,000
Above R 20,000
Additional Income
Child Care Grant
Disability
Other

Other Children

Admission Form 6

Guardian Details

Telephone Numbers

Following Details

Only To Be Completed If Guardian Is Responsible For Fee Payment

Email

Fax Number

Occupation

Income
Below R 7,000
Above R 7,000
Above R 20,000
Additional Income
Child Care Grant
Disability Grant
Other
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