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Admin No:

Collegiate Girls’ High School The Admissions Secretary, Kestell Street, Parsons Hill

P O Box 27870 Greenacres 6057 Tel: +27 (0)41 373 7705 Fax: +27(0)41 374 2817

Email: collegia@cghs.co.za / Website: www.collegiatehigh.co.za

APPLICATION FOR ADMISSION

Applications, addressed to the Admissions Secretary, should reach the school by the closing date and must be accompanied by an application fee of R50 (Cheques payable to Collegiate Girls’ High School). Applications will be accepted ONLY with submission of ALL relevant certified documentation as stated as the end of this application form. Please ensure that you complete ALL sections of this form. The supplying of false information will invalidate this application.

Closing date for Grade 8 (2018) applications: 31 March 2017 Grade 9-11 applications will be considered should a vacancy exist in the grade. If there is no vacancy initially, applications will be

retained and considered if a vacancy should occur during the course of the year.

Application for admission into grade (Mark with an X)

8 9 10 11

Please attach ID size photo of applicant in this space

Application for admission as a (Mark with an X)

Day Pupil (School only)

School and Boarding House Pupil

Current School

Date (Year) from which admission required

DETAILS OF APPLICANT

SURNAME:

FIRST NAME(S):

Called/Preferred name:

Identity number:

Home language: Nationality:

Religion/Denomination: Race: (for Dept. Stats)

A B C I W Other

Medical conditions:

Learning disabilities: Please complete attached Special Education Needs form and submit it with your application

Physical disabilities:

ADDRESS AND CONTACT DETAILS OF APPLICANT (LEARNER) A (Asian); B (Black); C (Coloured); I (Indian); W (White); O (Other)

Address:

If an immigrant/ non-South African citizen, please include a copy of passport and work/study permit and state date when entered SA schooling system: Date when entered schooling system:

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APPLICANT’S ACADEMIC PERFORMANCE

A copy of applicant’s latest end-of-year school report MUST be attached to this application; failure to do so will result in the application not being processed.

Has the applicant previously repeated a

Grade? YES NO If YES, which grade?

ADDITIONAL INFORMATION ON APPLICANT

Applicant living with:

Both parents Mother Father Guardian Other

Parent(s) deceased:

None Mother Father Both

Communication to:

Both parents Mother Father

Names of sisters currently at Collegiate Girls’ High School:

Name: Grade: House:

Name: Grade: House:

APPLICANT’S REASON FOR WANTING TO ATTEND COLLEGIATE GIRLS’ HIGH SCHOOL

To be completed by pupil (not the parent):

APPLICANT’S EXTRA-CURRICULAR ACTIVITIES

Cultural Activities:

Summer Sport:

State highest team/achievement

Winter Sport:

State highest team/achievement

Leadership positions:

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MOTHER’S DETAILS

SURNAME: TITLE: (eg Mrs /Ms / Dr / Adv)

FIRST NAME(S):

Identity number:

Marital Status (please indicate with an X)

Single Married Separated Divorced Living

together Remarried Widowed

Telephone numbers: HOME: WORK:

CELL: FAX:

Email address:

Residential address:

Postal code:

Postal Address:

Postal code:

Occupation:

Employer:

If self-employed, please supply company registration documents and VAT registration documents

FATHER’S DETAILS

SURNAME: TITLE: (eg Mr/ Dr / Adv)

FIRST NAME(S):

Identity number:

Marital Status (please indicate with an X)

Single Married Separated Divorced Living

together Remarried Widowed

Telephone numbers: HOME: WORK:

CELL: FAX:

Email address:

Residential address:

Postal code:

Postal address:

Postal code:

Occupation:

Employer:

If self-employed, please supply company registration documents and VAT registration documents

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If remarried – STEP-FATHER’S DETAILS

SURNAME: TITLE: (eg Mr/ Dr / Adv)

FIRST NAME(S):

Identity number:

Telephone numbers: HOME: WORK:

CELL: FAX:

Email address:

Occupation:

Employer:

If remarried – STEP-MOTHER’S DETAILS

SURNAME: TITLE: (eg Mrs/Ms / Dr / Adv)

FIRST NAME(S):

Identity number:

Telephone numbers: HOME: WORK:

CELL: FAX:

Email address:

Occupation:

Employer:

INFORMATION REGARDING PAYMENT OF SCHOOL FEES Please note that Collegiate Girls’ High School is a declared FEE-PAYING SCHOOL in terms of the relevant legislation, and that by enrolling

your daughter at the school, you are accepting an obligation to contribute financially towards the education she receives. School Fees are payable monthly by Debit Order or annually in advance by 31 January.

Who will be responsible for the school fees?

NAME: CELL NO:

Payment method: Annual Payment Debit Order

DETAILS OF DEBTOR if NOT Father or Mother

SURNAME: Title:

FIRST NAME(S):

Identity no: Email:

Home phone no: Cell no:

Work phone no: Fax no:

Physical address:

Postal address:

Occupation:

Employer:

If self-employed, please supply company registration documents and VAT registration documents

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DETAILS OF APPLICANT’S GUARDIAN (if applicable) (Please attach certified copy of Guardian’s ID documents to this application; failure to do so will result in the application NOT being

processed. If a legally appointed Guardian, please attach the court order.)

SURNAME: Marital Status of Guardian

FIRST NAME(S): Single Married Widowed Divorced

Identity no: Email:

Home phone no: Cell no:

Work phone no: Fax no:

Physical address:

Postal address:

Occupation:

Employer:

If self-employed, please supply company registration documents and VAT registration documents

CURRENT SCHOOL DETAILS

NAME OF PRESENT SCHOOL:

ADDRESS:

Telephone numbers:

PAYMENT DETAILS TO BE COMPLETED BY BURSAR AT PRESENT SCHOOL

CONTACT PERSON/BURSAR at present school:

NAME OF PERSON responsible for payment of fees:

Annual School Fees:

How are the Fees paid: Debit Order Cash Bank Transfer

Monthly payments: Overdue Balance owing as at date of application:

Signed by Bursar: Date:

SCHOOL STAMP

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TERMS AND CONDITIONS

I/We understand: 1. that in terms of a resolution adopted by the majority of parents at the Annual General Meeting of parents, payment of school

fees is obligatory and that I/we as parents am/are liable for such school fees, which liability may be enforced by due process of law in the event of non-payment. I/we declare that I/we am/are in a financial position to pay the school fees as adopted;

2. that payment is to be effected by one of the methods stipulated by the School Governing Body contained in its policy of fees structure;

3. that both parents are jointly and severally liable for payment of such school fees; 4. that in the event of school fees not being paid by the due date, whether by way of monthly instalment or by debit order, such

failure on my/our part will cause the whole outstanding balance of the annual school fees to become immediately due and payable;

5. that in the event of the school being obliged to hand over for collection through its attorneys any outstanding school fees, I/we shall be liable for the legal costs incurred by the school for the collection of such outstanding fees on a scale as between attorney and client, including such collection commission which the school may be obliged to pay to its attorneys;

6. that I/we shall be liable to pay interest on any school fees not paid on the due date for payment of such fees at the rate of 2% per month calculated from due date to payment in full.

7. that I/we am/are to give written notice of not less than one school term in advance of my/our intention to remove the pupil from the school. Failure to do so will result in my/our paying a term’s fees in lieu of notice.

DECLARATION BY PARENT/GUARDIAN

I declare that all particulars furnished by me on this form are true and correct.

In my personal capacity and on behalf of the applicant in my capacity as parent/guardian I hereby agree to: o Abide by the Code of Conduct attached to this document and acknowledge that I have read it and shall detach it and

keep it. o Abide by the School Rules attached to this document, also to be detached and kept for reference; o Acknowledge the authority of the Principal, the teachers and pupil leaders; o Pay the stipulated school fees as agreed by the Parent Body at the Annual Budget Meeting; o Pay any bank charges, legal fees and interest on any outstanding fees; o The school transmitting details of how the parent/guardians have performed in meeting their obligations in terms of

their school fee obligations; o Notify the Principal, in writing, in the event of my child leaving the school at least a term in advance or pay a term’s

fees in lieu of such notice. (This is for reasons other than disciplinary or financial default.) o Undertake to return all books and other property belonging to the school; o Ensure that my daughter attends school regularly and, should my daughter be absent from school for any reason,

inform the school of that in writing; o Pay all costs incurred for damage done or losses caused by my daughter to school property.

I will take responsibility for ensuring that my daughter is adequately insured against any personal injury or related risks. I will also ensure that her personal belongings are adequately insured against loss. I understand and agree that the school staff, assistants or helpers cannot be responsible for any losses, injury or damage incurred howsoever or from whatsoever cause arising. I indemnify and hold harmless the School and staff against any claims whatsoever related to my daughter.

Whilst my daughter is involved in school activities, I authorise the Principal (or appointed staff member) to act in loco parentis, including granting consent for medical treatment in the case of an emergency, once all reasonable efforts to contact the pupil’s parents have been made.

This is a fee-paying school and as parents we undertake to pay the fees in full according to arrangements agreed to on the Acceptance form.

I have read the attached Resolutions.

Signed at ………………………………………………………………………….this ................................ day of .................................................................. 2017 FATHER MOTHER MALE GUARDIAN FEMALE GUARDIAN

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THE FOLLOWING FORMS MUST ACCOMPANY THIS APPLICATION: FOR OFFICE USE ONLY:

1. Certified copy of birth certificate or identity document of the pupil.

2. Certified copy of identity document of each parent and/or guardian or debtor. If identity documents of both the mother and the father are not available, a certified copy of an unabridged birth certificate of the leaner is required.

3. Certified copy of passport, work permit, study permit, in the case of the applicant being a non-South African citizen.

4. Copy of latest report from the pupil’s present school. If the mid-year report is not available at the time of submission, the previous year’s December report should be submitted and the mid-year report be forwarded as soon as this is available.

5. Copy of the most recent utilities (lights/water/rates) account as proof of residential address.

6. An ID size, recent photograph of your daughter.

7. If either parent is self-employed, please supply company registration documents or VAT registration documents.

8. Should you qualify for a SASSA grant, please attach copies of all relevant documentation and a copy of the SASSA card.

YOUR APPLICATION WILL NOT BE CONSIDERED IF THE ABOVE-MENTIONED ITEMS DO NOT ACCOMPANY THE APPLICATION FORM, NOR WILL IT BE CONSIDERED IF NOT COMPLETED IN FULL.

PLEASE NOTE THAT NO INTERVIEWS FOR UNSUCCESSFUL APPLICATIONS WILL BE GRANTED.

FOR OFFICE USE ONLY:

RECEIVED ON: APPL. FEE RECEIPT NO:

HOUSE: CLASS:

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SCHOOL ETHIC AND CODE OF CONDUCT The Collegiate aims at providing

sound holistic (academic, cultural and sporting) education

a stable disciplined and aesthetic learning environment and instilling in our pupils

a high code of ethics, based on Christian principles

an awareness, tolerance and understanding of others

in order to enable each student to grow into a confident, independent, well-rounded and mature young adult prepared to participate actively and responsibly in the community.

The tradition and good name of the School have been built up over more than a century and every girl who wears the Collegiate uniform therefore has a responsibility to maintain the high standards which have been set in the past.

A. PUPIL RESPONSIBILITIES 1. Primarily to learn 2. Effective learning involves:

Developing to the full potential

Being motivated, independent and self-disciplined

Participating in extra-mural activities

Development of responsibility and leadership skills 3. Effective learning needs:

Mutual respect within and among groups

Respect for parents and the community

Regular and punctual attendance

Application to homework

Avoidance of anti-social behaviour

Adherence to rules and regulations

Tolerance of the opinions and beliefs of others

Full co-operation during lessons B. GENERAL CONDUCT

Collegiate pupils are expected to maintain a high standard of morality and integrity at all times. • Criminal activity and the use or possession of alcohol, drugs and/or narcotics are strictly prohibited.

C. DISHONESTY – THE RIGHT TO SEARCH

Dishonesty in any form will not be tolerated

Pupils acknowledge the School’s right to search in the event of suspected theft or possible presence of prohibited substances.

D. PRIDE IN OUR SCHOOL Pupils are expected to:

Take pride in their appearance, particularly when wearing the school uniform, which must be worn as stipulated in the rules, in particular that no jewellery other than a watch and/or a Medic Alert disc may be worn.

Take pride in their school premises by ensuring that classrooms and grounds are kept neat and tidy at all times

Respect and maintain the traditions of the school

Ensure that their conduct at all times does not bring the good name of the school into disrepute.

Observe and adhere to internal school rules, which should be read in conjunction with the code of conduct.

E. DISCIPLINARY PROCEDURES We endorse the principle of progressive discipline aimed at correcting misconduct and the sanction of suspension and/or expulsion will be sought in instances of serious misconduct.

This must be read in conjunction with the School Rules.

Each learner must complete a LEARNER COMMITMENT form which will be placed in the learner’s personal file by the Class Teacher.

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SCHOOL RULES

The Code of Conduct should be read in conjunction with the following School Rules.

1. GENERAL CONDUCT 1.1 All pupils should demonstrate respect, consideration and dignity at all times. 1.2 Pupils are expected to stand aside at doorways and entrances to allow adults and/or more senior pupils to pass through

first. 1.3 The usage of all electronic devices must be in accordance with the School’s IT and Cell Phone Policies (available at

www.collegiatehigh.co.za) 1.4 The School will not tolerate:

Dishonesty of any kind; Theft; Cheating in tests or examinations; Fraud;

Obscene and foul language; Bullying; Any acts of aggression or violent behaviour of any form; Graffiti and vandalism of any kind; Initiation, as stipulated by National Legislation; Hate speech; Racism in any form against any group is unacceptable; Any action which will bring the name of the school into disrepute. 2. ALCOHOL 2.1 The use of alcohol by a Collegiate girl, regardless of her age, is not permitted, on or off the campus, when she is involved in

any school-related event or activity; is in school uniform; or is clearly identifiable by the general public as a Collegiate girl. (Use of alcohol includes: showing any evidence of the use of alcohol; the purchase or selling of alcohol; being in possession of alcohol; being under the influence of alcohol.)

2.2 Furthermore, in relation to alcohol, no girl is permitted to bring the School into disrepute at any time or place, or under any circumstances.

2.3 Moreover, School Prefects and Hostel Seniors are entrusted with the responsibility of being role models to others and custodians of the School's good name, reputation, values and standards. To uphold these values and to avoid any ambiguity, no Prefect or Hostel Senior may, during her term of office, consume any alcohol, except in the privacy of her own home whilst in the presence of her parents and with their consent.

3. NICOTINE, DRUGS AND OTHER BANNED SUBSTANCES 3.1 No girl may bring onto the school premises any form of alcohol, tobacco, nicotine, marijuana, intoxicating drugs or any

other banned substance. 3.2 The possession and/or use of intoxicating drugs or any other banned substance in any place at any time is prohibited. 3.3 No girl may smoke or be in possession of nicotine or tobacco containing substances, electronic cigarettes or hubbly bubbly

pipes, whilst in her school uniform, or when identifiable as a Collegiate Girl. 3.4 Any girl found in possession of medication that has a schedule 4 or 5 classification, will within a 24-hour period make a copy

of the medical script issued by a medical doctor available to the school. Should this certificate not be provided, the medication will be deemed an illegal substance.

4. GENERAL APPEARANCE (in the case of a dispute, the final decision will rest with the Principal).

Collegiate girls are expected to take pride in their appearance and to be neat and well-groomed. Unless otherwise stated, uniform must be worn at all school and sporting activities, including those of Grey High.

4.1 SCHOOL UNIFORM

Name badges must be worn and visible on the top garment when at school.

Dresses and gyms length must be a maximum of 8 cm above the knee.

Regulation socks are to be folded over neatly. Only black secret socks may be worn underneath stockings.

Regulation black opaque stockings which are laddered or torn may not be worn. A spare pair of stockings should be in a girl’s possession at all times.

Belts are to be worn appropriately with winter gyms.

Jerseys are to be the correct size and may not be worn as the outer garment in the street, and may not have logos on them other than the school badge.

Blazers form part of both summer and winter uniform and must be worn outside the school grounds (this includes when a pupil enters or alights from a car when travelling to or from school). Blazers may be removed when in the classroom and during break; however, they must be put on again at the end of break.

Blazers are to be worn for the duration of all formal functions, and when representing the school.

When seated in a coffee bar or restaurant, girls may remove their blazers.

No part of the tracksuit may be worn with the formal school uniform.

Regulation school shoes must be worn.

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White scarves may be worn only by members of the 1st teams. No scarves may be worn at assemblies (be the assembly formal, informal or for a Carols Rehearsal) and formal functions when representing the school.

Rainproof jackets may not be worn in a classroom.

White Jackets are for sports and debating first teams, and may be worn in place of rain jackets.

Tracksuits are sportswear and may not be worn in the classroom, except where House Dress is mandatory, or when a pupil is required to change at second break into sports uniform either to attend a practice, Phys Ed, or a match directly after school.

Girls who have Phys Ed classes may change back into their school uniform at the break following their Phys Ed lesson. Girls who have Phys Ed in the last lesson of the day, may go home in Phys Ed clothing.

Drama pupils may change into their Drama Practical Outfits after Assembly, or at 1st or 2nd break, depending on the time of their practical lesson.

Matric tops are informal wear, and may not be worn as part of the formal or sports uniform.

Only officially designed and approved items may be worn as part of the formal school uniform.

Regulation house t-shirts must be worn by competitors and spectators at specified House events.

4.2 HAIR

Hair is to be clean and tidy. Specifically:

If longer than collar length (with the exception of straight back cornrows), hair must be tied back neatly.

Hair accessories: only plain navy, black, or dark brown are permitted. Sweat bands may be worn only for sport.

Hair must be out of one’s eyes.

No leather accessories or butterfly/banana clips.

Telephone wire must be transparent.

Hair should not be coloured or highlighted.

No spiked, punk or any other unorthodox styles are permitted. Braiding must match the girl’s natural hair colour. Box braids are not allowed.

A bun and ponytail must be neat and tidy.

4.3 NAILS

Should be of medium length so as not to draw unnecessary attention.

Only clear nail varnish is permitted. False nails may not be worn at school. No tips nor French manicures are permitted.

4.4 SCHOOL BAGS

Must be the regulation Collegiate school bag as purchased at the College Girl, or an identical navy school bag.

Bags must be clearly marked inside with the owner's name and initials outside.

Regulation school bags on wheels are permitted.

Tog bags and backpacks (school regulation only) are only for sports equipment, not books (except during exams). No stickers or graffiti to be on bags carried with school uniform. No other bags are permitted.

4.5 SPORTS UNIFORM

The regulation Physical Education kit must be worn at all Physical Education lessons and for all sports practices.

Physical Education kit: Navy (regulation) shorts or skorts and white top.

Team members must wear correct team uniform for all matches.

Only school tracksuits may be worn with sports kit.

No jerseys are to be worn with sports kit: only Collegiate warm-up tops are allowed.

After Water Polo and Swimming practices and matches, girls may not leave the school premises wearing only a costume and towel.

4.6 GENERAL

No makeup whatsoever is permitted.

All clothing and belongings are to be clearly marked.

Tattoos of any kind (permanent, temporary, henna or any other kind) must not be visible when wearing the school uniform or sports uniform.

Wearing earphones in public whilst wearing school uniform is not permitted.

No jewellery other than a watch or medic alert disc is permitted. All piercings must be empty.

5. PUNCTUALITY AND SCHOOL ATTENDANCE 5.1 The bell rings at 07:40 at which time all pupils are to be in their classroom for the registration period. 5.2 Pupils are to move as quickly and quietly as possible between lessons in single file, and observing the keep left rule. 5.3 No girl may leave the school premises during school hours without prior permission from the Principal on written request

from the Parent. When leaving, pupils must present this signed permission note to the Secretaries' office. 5.4 In cases of illness, the pupil is to report to the Grade Head with her note from her subject teacher. If the pupil needs to go

home, she will be sent down to the secretary, who will make the necessary arrangements. A Boarder must go to the Hostel Superintendent after seeing her Grade Head. No pupil may phone home and request to be fetched.

5.5 Pupils are to be in the classroom during lesson times, and the public phone may be used only during break times or after school.

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5.6 All absences must be followed by the prescribed explanatory note form (available in the School Diary) from the parent to the Class Teacher on the day the pupil returns to school. Additional copies of this form may be obtained from the class teacher.

5.7 A doctor's certificate or other recognised certificate is required if a pupil misses a test, a formal assessment or an examination, or if the absence has been for more than three days. (This must be read in conjunction with the applicable section in the school diary.)

5.8 Pupils are expected to attend school every day during term time unless prevented from doing so through illness or on genuine compassionate grounds.

5.9 Pupils who have not attended school on a specific day, or who have left school early due to poor health, may not participate in any school activities on that day or evening.

6. CLASSROOMS, SECURITY WITHIN THE SCHOOL GROUNDS, AND MOTOR VEHICLES 6.1 The following are out of bounds:

The Hospitality, Consumer Studies and Art Rooms, all Laboratories, the Gym Hall and Auditorium, and all other classrooms, during break and after school, unless permission is granted by a teacher.

The Hostel for day girls except by special permission from the Superintendent.

The centre steps of the quadrangle.

The Music corridor.

The front entrance except for evening functions, or when being fetched by a parent during school hours.

The staffroom at all times.

The main staircase to all girls, except the Prefects.

The gallery above the stage except with permission from a teacher. The catwalk into the roof is out of bounds at all times.

All gymnastic equipment unless a teacher is present.

The entire garden area in front of the school.

The Entrance Foyer except for those needing to see the Principal or Secretary or waiting to be fetched.

Ivy Leaf, except during break or after school for special functions. Only Grade Twelves may sit in the Ivy Leaf during breaks.

Beyond the hockey field next to the astro turf and the entire area south of Jenkins way (i.e. the swimming pool side). 6.2 Only one person at a time is allowed in a toilet cubicle. The privacy of a pupil is to be respected at all times. 6.3 Water bottles may not be made from glass, and must be of a reasonable size. 6.4 Balloons are only allowed on the campus during the school day with the express permission of the Principal. 6.5 Parents or bona fide guests should announce themselves at the front office. 6.6 Girls are to remain within the school grounds whilst waiting to be fetched by parents. From 15:00, girls must be collected

from the Kestell Street entrance. 6.7 Grade 12 pupils who have a valid driver's license are allowed to apply for permission to park on the school grounds. 6.8 Girls are to be silent in the blue area. 7. EXEMPTION FROM THE SCHOOL RULES

Should a pupil wish to apply for an exemption from a school rule, an application must be made in writing by the pupil and her parents to the School Governing Body.

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Resolution 1 Approval of the Budget for 2017 The Budget as tabled for 2017 was approved. Resolution 2 School Fees 2.1 Collegiate Girls’ High School is a fee paying school 2.1 School Fees are determined and charged by the school. 2.2 School Fees for 2017 shall be R34 925 per annum per learner 2.3 School Fee payment options:

The school will accept payment in instalments on the following basis:

Payment monthly in 11 equal instalments of R3 175 payable in advance on the last day of each month (beginning in January). If one instalment is missed, then the full year’s outstanding fees become due and payable.

A once off discounted payment of R R32 000 payable by 31 January 2017.

Monthly school fees will be paid by Debit Order.

Money received from parents will be first allocated to school fees and then to, if applicable, Hostel fees.

Non-payment of Hostel fees will lead to immediate expulsion from the Hostel. 2.4 Sports and Cultural Tours are offered on a voluntary basis and partial funding is included in the school fees. Parents will thus be required to participate in contributing to funding of these tours.

Resolution 3 Equitable criteria and procedures for the total, partial or conditional exemption of parents from the payment of school fees. 3.1 It is resolved that the following procedures will apply:

A parent who wishes to be exempted from the payment of school fees for a child at Collegiate Girls’ High school shall apply annually to the Chairperson of the Governing Body in writing by completing the relevant forms and returning these forms to the school within seven days of collection.

The Parent will attend an interview with the SGB.

The Chairperson and the Treasurer will evaluate each application by applying the relevant legislation and regulations before granting or declining an application.

Applicants will be informed in writing by the Governing Body of the outcome within 30 days of the parent lodging the application, providing that all relevant documentation be submitted with the application.

Appeal procedures are provided, in terms of the relevant legislation, for any parent who is dissatisfied with the decision.

3.2 It is resolved that the equitable criteria for the total, partial or conditional exemption of parents, who are unable to pay compulsory school fees, be determined in accordance with the criteria set out in the Exemption of Parents from School Fees regulations (as amended in Government Gazette 39392 of 17 November 2006).

Resolution 4

It is resolved that the Governing Body is authorized to make payments to state paid educators in terms of Section 38A of SASA and the sum allocated towards Section 38A payments is reflected in the budget, as tabled, and accepted.

Resolution 5 It is resolved that the Budget, as tabled, reflects the estimated cumulative effect of: 5.1 The established trends of non-payment of school fees and 5.2 The total or conditional exemption granted to parents in terms of the regulations.

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Collegiate Girls’ High School The Admissions Secretary, Kestell Street, Parsons Hill Private Bag 27870 Greenacres 6057 Tel: +27 (0)41 373 7705 Fax: +27(0)41 374 2817 Email: collegia@cghs.co.za / Website: www.collegiatehigh.co.za

STUDENTS WITH SPECIAL EDUCATION NEEDS ASSESSMENT The Department of Education conducts an annual EMIS audit amongst all schools throughout South Africa, and require various statistics regarding our current student body. Unfortunately, as a result of many junior schools no longer collating ed-lab cards and the relevant information contained therein, we are not in a position to determine accurately certain statistics required by the Department. One such statistic is that pertaining to students with special educational needs. We are required to provide the Department with all information regarding any student who is classified as such student. In addition, we are required to provide any details of testing conducted by a registered and professional assessor. In terms of the Department’s classification the following categories of special needs exist: BLIND: Students who experience a severe visual impairment and who depend on specialised education support; PARTIALLY SIGHTED: Students who experience visual impairment and are in need of additional help; DEAF/BLIND DISABLED: Students who are completely deaf and blind; CEREBRAL PALSIED: Injury of the spine and must be declared medically as such by a medical practitioner; SPECIFIC LEARNING DISABLED: Students who experience severe barriers to learning e.g. in the form of reading or writing and who are in need of additional specialised help; BEHAVIOURAL DISODER (includes severe behaviour problems): Students with a severe behavioural disorder of such a degree that it is difficult to accommodate them in an ordinary class; MILD OR MODERATE INTELLECTUALLY DISABLED: Students who experience moderate intellectual disability and are more than two years behind their peers; SEVERE INTELLECTUALLY DISABLED: (includes severely mentally handicapped): Students who experience severe intellectual disability and are more than two years behind their peers; PHYSICALLY DISABLED: Students with a significant physical disability and who are in need of additional specialised support; AUTISTIC SPECTRUM DISORDERS: Students experiencing pervasive development disorder. Must be declared as such by a medical practitioner; EPILEPSY: Students who experience barriers to learning owing to epilepsy and who are in need of additional specialised support. Must be declared medically as such by a medical practitioner; ATTENTION DEFICIT DISORDER WITH/WITHOUT HYPERACTIVITY: Students who experience barriers to learning owing to attention deficit disorders and who are in need of additional specialised support. It is imperative that the school provides information which is as accurate as possible, since the Department allocates the school its staffing complement based on the abovementioned statistics. Therefore, should the Department believe that we have the necessary number of students with special needs, we will be provided with additional staff to assist such students. In light of the above, please peruse the list carefully and then complete the attached reply slip, if necessary, and return to the school in a sealed envelope. Please note that any information you provide will be treated in absolute confidence and will in no way have any detrimental effect on your daughter. Additionally, should your daughter be included in any of the abovementioned categories, the Department may at a later stage require supporting documentation from registered and professional assessor. MRS M BAGSHAW PRINCIPAL

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NAME OF STUDENT:

NAME OF PARENT / GUARDIAN:

CONTACT TELEPHONE NUMBERS: WORK:__________________________ HOME: _________________________CELL: __________________________

Please select the Special Education Needs category in which your daughter falls, by ticking the relevant category:

1 Blind Students who experience a severe visual impairment and who depend on specialised educational support

2 Partially sighted Students who experience visual impairment and are in need of additional help

3 Deaf/blind disabled Students who are completely deaf and blind

4 Cerebral palsied Injury of the spine and must be declared medically as such by a medical practitioner

5 Specific learning disabled Students who experience severe barriers to learning e.g. in the form of reading or writing and who are in need of additional specialised help

6 Behavioural disorder (includes Severe Behavioural problems) Students with a severe behavioural disorder of such a degree that it is difficult to accommodate them in an ordinary class

7 Mild or moderately intellectually disabled Students who experience moderate intellectual disability and are more than two years behind their peers

8 Severe intellectually disabled (includes Severe Mentally Handicapped) Students who experience severe intellectual disability and are more than two years behind their peers

9 Physically disabled Students with a significant physical disability and who are in need of additional specialised support

10 Autistic Spectrum Disorders Students who experience barriers to learning owing to epilepsy and who are in need of additional specialised support. Must be declared medically as such by a medical practitioner

11 Epilepsy Students who experience barriers to learning owing to epilepsy and who are in need of additional specialised support. Must be declared medically as such by a medical practitioner

12 Attention Deficit Disorder with/without Hyperactivity Students who experience barriers to learning owing to attention deficit disorders and who are in need of additional specialised support (supporting medical documentation to be attached to this form)

Additional comments you would like to bring to the attention of the Grade Head:

______________________________ _____________________ SIGNATURE OF PARENT/GUARDIAN DATE

STUDENTS WITH SPECIAL EDUCATION NEEDS Application Form - Private & Confidential