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APPLY NOW

Start you career today as a Healthcare worker by filling in the application form below.

A Registration Fee of R200 will be required after submitting this form.

Course Information

Select your Course:

Learner Information

Full Names *

Surname *

Preferred Name

ID Number *0 / 13

Date of Birth

Nationality

Other

Religious Denominations

Gender

Ethnic Group

Home Language

If "Other", what is your home language?

Language Preference

If "Other", what is your language preference?

Upload Learner Photo

No file chosen

Contact Information

Mobile Number *0 / 10

Email Address

Street Address

City

Province

Education

Admission Date

Grade in 2021

Years in grade for 2021

Years in phase for 2021

Pre-primary education attended

If "Other", what pre-primary education did you attend?

Transport

Method of Transport

Taxi/Bus registration number

Name of Driver

Contact Number *0 / 10

Family Information

Family Status

Parents Deceased

MotherFatherNone

Next of Kin

Name

Relation

Contact Number

Alternative Contact Number

Health Information

Chronic diseases

Allergies

Medication

Medical Aid Information

Name

Member Number

Primary Member

Contact Number

Family Doctor Information

Name

Contact Number

Business Address

Previous School

Please provide information for your previous School/Play Group/Nursery

First registration of learnerYesNo

Learner attended school last yearYesNo

If yes, in which Province/Country?

Previous school

Contact Number

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Highest grade in previous school

Reason for leaving the school?

Biological Parent / Legal Guardian 1

Title

Full names

Surname

Initials

Preferred Name

ID Number

Home Language

If "Other", what other language is spoken?

Language Preference

Communication PreferenceSMSE-mailMailBy handChoose all that apply.

Mobile Number

Home Number

Fax Number

Email Address

Residential Address

Postal Address

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Country

Occupation status

Occupation

Employer

Phone

Street Address

City

State/Province

ZIP / Postal Code

Country

Is the learner living with this parent?YesNo

Biological Parent / Legal Guardian 2

Title

Full names

Surname

Initials

Preferred Name

ID Number

Home Language

If "Other", what other language is spoken?

Language Preference

Communication PreferenceSMSE-mailMailBy handChoose all that apply.

Mobile Number

Home Number

Fax Number

Email Address

Residential Address

Postal Address

Street Address

City

State/Province

ZIP / Postal Code

Country

Street Address

City

State/Province

ZIP / Postal Code

Country

Occupation status

Occupation

Employer

Phone

Street Address

City

State/Province

ZIP / Postal Code

Country

Is the learner living with this parent?YesNo

Accountable Person's Information

Who is the accountable person?

Type of Accountable Person

Individual

Company / Closed Corporation / Trust

Title

Full names

Surname

Initials

Name

Registration Number

Preferred Name

ID Number

Home Language

If "Other", what other language is spoken?

Mobile Number

Contact Number

Fax Number

Email Address

Language Preference

Communication PreferenceSMSE-mailMailBy handChoose all that apply.

Residential Address

Business Address

Street Address

City

State/Province

ZIP / Postal Code

Country

Use the address above for the Postal Address?Yes

Postal Address

Street Address

City

State/Province

ZIP / Postal Code

Country

Agreement between Thutobophelo Training & Skills Academy Pty (Ltd) and

Name of Parent/Guardian *

with regards to the payment of school fees.

Accept responsibility for the payment of fees for above child before or on the seventh (7th) day of each month:

Payment Method

I agree to inform the Principal in writing if I am unable to pay the fees. My child's admission will be secured for one (1) month.
I understand that the school will take the necessary legal steps to recover any outstanding fees.
I agree to give one (1) calendar month's notice should my child no longer attend school. In the last term, I undertake to give notice in October as November doesn't serve as a notice month.
I declare that the forms have been completed correctly. I have read and understand the acceptance requirements and school rules.
If you prefer to receive statements by e-mail, please indicate e-mail address

I / We the parents / guardian of

Learner Name *

undertake to honour the agreement as set out above.

Signed Date *

If registration fee is not paid your submission will not be processed. Please make payment after submitting your application.

You will be redirected to our Yoco Secure Payment Gateway after form is submitted.

Call Me Back

Name

Surname

Email Address

Contact Number

Province

Programme Of Interest

Message

Thutobophelo Training and Skills Academy provides nationally recognised entry level qualifications for the healthcare sector.

GET IN TOUCH

WhatsApp:
082 905 8355

Phone:
0123233375/9