Motlokoa R Services

Learn, Register, Design, Apply

About Motlokoa R

Learner Tutorial Registration Form

Student Information

ID Number:
First Name:
Last Name:
School:
Grade:
Age:
Phone Number:
Gender: Male Female

Languages

English Home Language
Afrikaans First Additional Language
Computer Studies

Educator's Details

Full Name:
Contact Number:

Parent's Details

Parent's ID Number:
Full Name:
Last Name:
Cell Number:
WhatsApp Number:
Occupation:
Title:
Residential Address:

Legal Guardian/Next of Kin Details

Full Name:
Last Name:
Cell Number:
Relationship:
Residential Address:

Transport Driver Details

Full Name:
Last Name:
Cell Number:

Signatures and Date

Student Signature:
Parent Signature:
Program Director:
Date:

Required Documents

Certified Copy of Child's Birth Certificate:
Certified Parents' ID Copy:
Proof of Residence:
Term 4 or Term 1 School Report:
Proof of Payment:
Application Fee Receipt:
Subject Fee Receipt:
List of Emergency Contacts:

Stationery

A4 2 Quire 192 Page Feint and Margin (Covered)
A4 Page Feint and Margin (Covered)
Presentation File
A4 Ring-binder
Blue Bic Fine Point
HB Pencil
4 Piece Highlighters
10 Piece Colour Pens
30cm Ruler
43g Pritt Glue Stick
A4 Size Calendar
School Timetable
Exam/Test Timetable

Before you submit your form make sure that you read Student Code of ConductView Code of Conduct