JOHN MACKENZIE HIGH SCHOOL

APPLICATION FORM

Photograph

NOTE:

The following must accompany this application:

v  A recent passport size photograph of applicant.

v  A copy of applicant’s birth certificate or passport.

v  A copy of the applicant’s most recent school report.

If applying for Form 1 a copy of the most recent Standard 7 report.

v  A letter of release from the applicant’s previous school. Not applicable to Form 1 applicants.

v  Proof of Residence if the applicant is not a citizen (Residence Permit).

v  A non-refundable registration fee of P100.

PUPIL’S NAME:
PLACE REQUIRED
IN FORM:
PROPOSED DATE OF ENTRY :
DETAILS OF PRESENT SCHOOL: / Name of School:
Address: / Telephone Number:
PRESENT FORM:
COURSE FOLLOWED AT PRESENT SCHOOL: / BGCSE / 4 YEAR COURSE
IGCSE / 5 YEAR COURSE
OTHER / Details:

Please tick where applicable

REASONS FOR LEAVING PREVIOUS SCHOOL:

Please complete all sections of the application form and return to:

John Mackenzie High School

P.O. Box 121

Francistown

Botswana

Tel: 2419799

PROSPECTIVE PUPIL’S DETAILS

Surname:
First Name/s:
First Name Child Uses at School:
Date of Birth: / Day / Month / Year / Male / Female
Place of Birth: / Town/City / Country
Nationality as per Passport:
Residence Status in Botswana: / Citizen / Permanent Resident / Temporary Resident
Pupil’s Cell Number: / Religion:
Languages spoken at home:
Physical Disabilities:
Illness/Allergies:
The applicant resides with: / Mom & Dad / Mom / Dad / Relative / Guardian
Postal Address for all school correspondence:
Medical Aid Provider / Medical Aid No / Name of Principal member
Name and phone number of family doctor:
Do you have any objections to your child receiving first-aid treatment in case of an accident or emergency? / Yes / No

Has your child ever been identified as having any specific learning need (is gifted or has a specific

learning difficulty)? If yes, please give details below:

Has your child received any specialised support for learning in the past? If yes please give details below:

Has your child’s behavior been identified as a concern at a previous school? If yes please give details below:

PARENT’S DETAILS

If the applicant does not reside with his/her parents please complete the Guardian’s section as well.

Father / Mother / Guardian
Relationship with Applicant:
Title:
Surname:
First Names:
Nationality:
Residence Status in Botswana / Citizen
Permanent Resident Temporary Resident / Citizen
Permanent Resident Temporary Resident / Citizen
Permanent Resident Temporary Resident
Telephone No: (H)
(W)
Fax Number:
Cell Number:
Email Address:
Marital Status: / Married / Single
Separated / Divorced Widow / Widower / Married / Single
Separated / Divorced Widow / Widower / Married / Single
Separated / Divorced Widow / Widower
Postal Address:
Residential Address:
Occupation:
Employer’s Name:
Employer’s Physical Address:
Employer’s Postal Address:
In an emergency, if none of the above are available, contact:

PARENTAL UNDERTAKING

I, Mr/Mrs/Ms: (full name), being the parent/legal guardian of (full name of child), hereby acknowledge that I have read and understood all the particulars in and of this application form and that all information given by me is accurate to the best of my knowledge.

·  I understand that the submission of this form and its acceptance by John Mackenzie High School does not, in any way, guarantee that a place will be made available for my child.

·  I understand that in order to secure a place in Form One, the prospective pupil will have completed seven (7) years of Primary Schooling.

·  I understand that by completing this form, I authorize the school’s Admission’s Office to contact my child’s previous school should further information be required in order to process this application.

·  Should my child be offered a place, I agree to be bound by the School’s Rules, Regulations and Code of Conduct.

·  I understand that the registration fee of P100.00 payable at the time of application, is non-refundable and I hereby agree that, should this application be successful and my child is offered a place at John Mackenzie High School, I shall be legally liable for the full payment, by the due date on the invoice(s), of all school fees and levies as stipulated from time to time.

·  I understand that, if my child is offered a place at John Mackenzie High School, and if I accept the place offered, in writing and on the proper form, the full amount of a non-refundable Capital Development Levy of P3000.00 must be paid before the child enters the school.

·  If this application is successful, I agree that I shall be legally required to give one term’s notice, in writing, of my intention to withdraw my child from John Mackenzie High School and that, failing to give such notice, I will be legally bound to pay the equivalent of one term’s school fees in lieu of notice.

Signed Mother: Date:

Signed Father: Date:

FOR SCHOOL OFFICE USE ONLY

Date application received: Received by:

Called for testing on: Registration Receipt No:

Place offered: To Start: