HOME EDUCATION USER MANUAL

The document uses macros…

Click the button titled “Enable Content” To enable macros.

Fill the form accurately.

Sending the form by email

Scroll to the last page, click the button titled “attach to email” and follow the prompts.

Take Note: The button creates an email (does not send it automatically); Attaches the application form to the email.

Other documents must be attached manually to the email.

Then click “send” button to send the email to provincial officials.

APPLICATION FOR THE REGISTRATION OF LEARNERS FOR HOME EDUCATION
General Information
This application form must be completed in full by the parents/ guardian of a learner. A separate form must be completed for each learner, accompanied by the following required documents : Please note: all certified copies must not be older than 3 months Certified copy of the learner’s birth certificate Certified copy of the learner’s last school report signed by the principal (if applicable) Certified copy of the parent’s ID In case of foreign nationals certified copies of passport /study permit/work permit is required. Certified copy of the transfer certificate from previous school (if Applicable) In case of a learner with special needs, attach certified copy of assessment document or Referral letter form the medical practitioner. Motivation why the parent wishes the learner to be educated at home. Full details of the educational programme (subjects, teaching hours per subjects, assessment, extra mural activities, excursions, library, programme use of tutor).
Instructions on how to complete this form: Complete the form by ticking check box Write in the text box where applicable Select relevant option from given options in a dropdown-list

1. Learner Details
1.1 Full Names: (As on birth certificate)
1.2 Surname:
1.3 South African Citizen : (Choose appropriate choice)
1.4 South African Identification Number :
1.5 Gender:(Tick Appropriate box)	1.6 Date of Birth : yyyy-mm-dd
1.7 Passport Number: (if applicable)	1.8 Country of Origin :
1.9 Population Group :	Other :
1.10 Assessed by registered professional practitioner :
1.11 Type of Disability: (tick appropriate box: If applicable) Please Attach Proof of Disability	Epilepsy	Partial Sighted/Low vision	Psychiatric disorder
Blindness	Attention Deficit Disorder	Autistic Spectrum Disorder
Deafness	Physical disability	Behavioural disorder
Hard of Hearing	Mild to Moderate Intellectual disability	Specific learning disability
Other	Severe to profound intellectual disability	Cerebral Palsy Blindness
If learner suffers from Other disability please Specify :
2. Last School Attended
2.1 Province of last school attended (if applicable)	2.2 Name of previous school attended (if applicable)
2.3 Grade completed (if applicable)	2.4-Physical address of the school (if applicable)
2.5 Contact No. of last school attended: (if applicable)
3. Home Education Grade Registering
3.1 Grade for which application is being made
3.2 Curriculum to be used
3.3 Subjects Offered (List all subjects, Separated by comma)
3.4 Home Education site address :
3.5 Reasons for choosing home education(Mark Appropriate)	Distance to school	Children With Special needs	Nomadic lifestyles
Dissatisfaction with public school	Religious Convictions	Financial Consideration
Lack of Admission to public ordinary Schools	If Other Specify :

4. Father Details/Legal Guardian
4.1 Title:	4.2 First Names:
4.3 Surname:
4.4 South African Citizen
4.5 South African Identification Number:
4.6 Passport Number: (if applicable)
4.7 Country of Origin(If not from South Africa)
4.8 Population Group:
4.9 Highest Qualification Obtained
4.10 Employment Status: (Please tick appropriate box)
4.11 Marital Status:(Please tick appropriate box)
4.12 If you are a member of a Home Education Association, please provide the name:
4.13 Lives with the Learner:
4.14 Relationship With Learner:
Other Specify :
4.15 Telephone Number:	4.16 Cell Number:
4.17 Email Address:
4.18 Residential Address:	Street:	House No.	Farm:
Complex/ Building :	Area Code:

5. Mother Details/Legal Guardian
5.1 Title:	5.2Full Names:
5.3 Surname:
5.4 South African Citizen
5.5 South African Identification Number:
5.6 Passport Number: (if applicable)
5.7 Country of Origin(If not from South Africa)
5.8 Population Group:
5.9 Highest Qualification Obtained
5.10 Employment Status(Please tick appropriate box)
5.11 Marital Status: (Please tick appropriate box)
5.12 If you are a member of a Home Education Association, please provide the name:
5.13 Lives with the Learner:
5.14 Relationship With Learner:
If other specify
5.15 Telephone Number:	5.16 Cell Number:
5.17 Email Address:
5.18 Residential Address:	Street:	House No:	Farm:
Complex/ Building :	Area Code:

6. Additional Person for Tutoring(if Applicable)
6.1 Full Names: (As on Identity Document)
6.2 Surname:
6.3 South African Citizen
6.4 South African Identification Number:
6.5 Passport Number: (if applicable)
6.6 If not South African Please State Country of Origin :
6.7 Qualification Attained :
6.8 Cell Number:
6.9 Telephone Number:
6.10 Email Address:
6.11 Residential Address:	Street:	House No:	Farm:
Complex/Building:	Area Code:

7. Declaration By Parent Or Guardian
I (name of parent/guardian) hereby declare that I have read sections 51 of the South African Schools Act, 1996 together with the Policy for the Registration of Learners for Home Education, 1999. I further declare that I understand and accept the responsibility to provide, monitor and assess the home education of my child and that I have supplied full and correct information. Initials of the Parent/Guardian Date :

8. OFFICE USE ONLY
8.1 Received By:	8.2 Verification Conducted By:	8.3 Application Approved	8.4 Reason for not Accepting
8.5 Issue of Certificate

Attach to Email

Clear the form