Short Course Enrolment Form

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SHORT COURSE CONTRACT OF ENROLMENT
Student Applicant Name:

Student Number :

Preferred Campus :

CAPE TOWN

JHB

Application Date :
CITYVARSITY CAPE TOWN 32 Kloof St, Gardens, Cape Town 8001 Tel 021 488 2000 Fax 021 423 6300 CITYVARSITY JOHANNESBURG 39 Gwi Gwi Mrwebi Street, Newtown, JHB 2001 Tel 011 634 9840 Fax 011 634 9840

[email protected] www.cityvarsity.co.za

Study Method (Please tick relevant box)
Short Course Workshop Corporate

www.cityvarsity.co.za

PROFESSIONAL EVENING SHORT COURSES
Documentation required with an application to enrol into a short course: 1) Copy of the applicant’s ID document; 2) Account payer’s salary slip, or a current 3-month bank statement; 3) Copy of account payer’s ID document; 4) Copy of Study Permit (if applicant is non-South African),

Section A: STUDENT APPLICANT DETAILS
Title Surname First name ID number Date of birth Gender Marital status Maiden name South African citizen Race* Black Yes No Indian Proof of ID or passport Coloured White Yes Other No Y Y Y Y M M D D Initials Mr Mrs Miss Prof Dr

CONTACT DETAILS (in South Africa)
Home telephone (incl. code) Work telephone (incl. code) Cellphone Fax number Email address Divorced Widow/er

Male Single

Female

Home language Married

RESIDENTIAL ADDRESS
Address Address Suburb City/Town Province, Country Code

NEXT OF KIN
Surname First name Telephone (incl. code) Relationship

POSTAL ADDRESS
Address Suburb City/Town Code

FOREIGN STUDENTS
Passport no. Date arrived in SA Nationality Y Y Y Y M M D D

Province, Country Preferred means of communication Email Telephone Mail SMS

Domicile

I hereby declare that I have received, read and understood the CityVarsity terms and conditions, relevant program information, and the schedule of applicable tuition fees which shall apply mutatis mutandis to me in my full capacity.

Tick here if you DO NOT want to receive CityVarsity marketing or promotional information by email or SMS. How did you find out about us? Word of mouth School Visit Career Expo CityVarsity Website Pamphlet/Brochure Advertisement (please specify)

Student Applicant signature

STUDENT APPLICANT REGISTRATION SECONDARY EDUCATION
Matriculation: School Year achieved Y Y Y Y Matriculation Exam Board Without Exemption Conditional

SHORT COURSE REGISTRATION
Course Course code Cost Starting date Yes No Full Exemption

Matriculation status

Matriculation Certificate no.

TERTIARY EDUCATION
Have you previously studied at a Tertiary Education Institution? If Yes, please state Name of Institution Student no. Qualification obtained Applying for Recognition of Prior Learning (RPL)? Yes No

Please initial here

* SA Citizens and Permanent Residents: Please complete, required by Dept of Education for statistical purposes.

If applying to pay tuition fees through a CityVarsity repayment plan, Account payer to provide a copy of their pay slip (or a current 3-month bank statement), and a copy of their ID document.

Section B: CREDIT APPLICANT / ACCOUNT PAYER DETAILS
Title Surname First name ID number Home telephone (incl. code) Work telephone (incl. code) Cellphone Email address Initials Mr Mrs Miss Prof Dr

FINANCIAL DETAILS Monthly income
Nett Salary (After deductions) Other Nett Income (After deductions) SUBTOTAL A

Monthly expenditure
Home loan repayment, or Rent Water, Electricity, Rates and Taxes Insurance (life and short term) (in South Africa) (outside South Africa) School and/or University fees Transport (Car payments, Fuel, Fares) Home maintenance Other expenses 1 (specify) Code Other expenses 2 Other expenses 3 Other expenses 4 Credit card repayments 1 Credit card repayments 2 Code Credit card repayments 3 Credit card repayments 4 Cheque account repayments 1 Cheque account repayments 2 Instalment sale agreement 1 Code Instalment sale agreement 2 Other loan repayments 1 Budget for annual expenses (TV License, Vehicle, etc) SUBTOTAL B Account Type SUBTOTAL A: Nett Monthly Income SUBTOTAL B: Total Monthly Expenses TOTAL: Monthly Disposable Income

RESIDENTIAL ADDRESS
Address Address Suburb City/Town Province, Country

POSTAL ADDRESS
Address Suburb City/Town Province, Country

WORK ADDRESS (in South Africa)
Address Suburb City/Town Province, Country

BANKING DETAILS
Account holder’s name Bank Branch code Account no.

1. I confirm that the above information reflects all my monthly income and expenditure as at the assessed date. I confirm that the information contained in this document is to the best of my knowledge, true and correct. 2. I, the undersigned, hereby consent that: a. CityVarsity will be entitled to verify the information contained on this Application Form and make whatever enquiries it deems necessary regarding the Student’s creditworthiness with any credit bureau. b. CityVarsity, including its holding, affiliated, or subsidiary companies, will be entitled to furnish any information in relation to any account of the Student with CityVarsity, including the Student’s creditworthiness and details with respect to how the Student has conducted their account with CityVarsity and the Student’s compliance or otherwise with these conditions, to any other creditor or to one or more credit bureaux. 3. If the signatory to this agreement is not the Student, then I, as the signatory, agree to bind myself jointly and severally, as surety and co-principal debtor, with the Student to CityVarsity for the due fulfillment of all and any obligations of the Student to CityVarsity.

Signature of Credit Applicant / Account Payer

Date

CONTRACT OF ENROLMENT TERMS AND CONDITIONS
Please initial each page to indicate that you have read and understood these terms and conditions. The student, applicant, account/fee payer, lawful guardian and/or sponsor are herein collectively referred to as the “Student”. By acceptance to CityVarsity, and where the Student has entered upon studies at CityVarsity pursuant to the Contract of Enrolment entered into with CityVarsity, the Student shall be jointly and severally responsible for the fulfillment of all terms of the agreement. 1. Compliance with CityVarsity Rules and Regulations The Student will comply with all the rules and regulations of CityVarsity as may be laid down from time to time with the intent and purpose of entering the highest possible academic standard and the best creative results from the whole Student body. Student Liability for damage or loss The Student shall be responsible to pay for all damage or loss caused by the Student to any property of CityVarsity or any other person lawfully on the premises of CityVarsity. Legal Declaration of Indemnity The Student hereby indemnifies CityVarsity against any risk, loss or damage of whatsoever nature or kind arising out of any claim, which may be preferred against CityVarsity as a result of any happening of whatsoever nature or kind which may take place on the premises of CityVarsity, or in connection with the affairs and activities of CityVarsity in which the Student takes part. Neither CityVarsity nor any official employee or representative of CityVarsity acting in his/her capacity as such shall be liable for any damage arising out of the death, bodily harm, loss of health or illness of any Student howsoever caused. Furthermore the Student hereby holds CityVarsity free from any claim of whatsoever nature or kind arising out of any loss or damage which may be suffered by the Student whilst on the premises of CityVarsity or in connection with the activities of CityVarsity, arising from any cause whatsoever. Neither CityVarsity nor any official employee or representative of CityVarsity acting in his/her capacity as such shall be liable for any damage to any property owned by or in the custody of any Student, howsoever caused. The Student hereby indemnifies CityVarsity against any claim made against CityVarsity in respect of any damages arising out of the fault of the applicant. Termination of Studies In the event of any Student desiring to terminate studies, for any reason whatsoever, this shall not absolve the Student or other Students to this contract from full liability for the payment of fees and any other charges. Copyright The Student accepts that any productions, including film, video, soundtracks, writings, recordings or any other products emanating from Student endeavours during any program at CityVarsity, shall vest in CityVarsity to whom all copyrights and ownership therein shall belong and without whose written permission no use may be made for broadcast or any other purpose. Academic Performance The Student accepts that in the event of the behaviour or academic progress of the Student being in any way reasonably unacceptable to the Principal of CityVarsity, such principal, in the exercise of his/her sole discretion, shall have the right to determine and cancel the Student’s entitlement to attend CityVarsity. Under no circumstances will the registration fee or other fees paid be refundable. Credit Approval By completing and submitting the application form, the applicant thereby authorizes CityVarsity to access any information available to assess his/her application, and also gives CityVarsity permission to conduct a credit check with any credit bureau or third party, and the applicant waives any claims he or she may have against CityVarsity in respect of such disclosures. This contract is accepted provisionally subject to the outcome of the credit check being acceptable to CityVarsity. CityVarsity hereby reserves the right to decline the application if it does not comply with the CityVarsity credit policy or meet CityVarsity’s credit granting criteria. Student fees In the event of any fees due by the Student being unpaid on due date, the full balance of such fees remaining unpaid shall become immediately due and payable. A statement of accounting reflecting the amount due by the Student and certified as correct by the Bursar of CityVarsity is hereby agreed to be prima facie evidence of the amount so certified and to support an Application for Summary Judgment by CityVarsity against the Student. CityVarsity reserves the right to cede the collection of fees to a finance house or other institution. In the event of any proceedings being instituted by CityVarsity against the Student then, by the signature hereto, the Student consents, in terms of Section 45(1) of Magistrate’s Court Act No 32 of 1994, as amended from time to time, to any proceedings which may be instituted in the Magistrate’s Court which has jurisdiction in terms of Section 28(1) of the Magistrate’s Court, as so amended, notwithstanding the amount of the claim. The Student shall be liable for all legal costs and charges on an attorney and client scale incurred by CityVarsity, as well as all tracing costs, collection costs, and any other disbursements which are incurred in recovering monies which may at any time be owed by the Student to CityVarsity. The Student shall accept a yearly fee increase in their 2nd and 3rd year of study. The Student will not receive reports, diplomas or exam results unless account is paid up in full. A Student who has failed the academic year shall not receive any reimbursement of their tuition fee. Foreign applicants are required to pay full fees prior to their studies.

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8. 8.1 8.2

8.3

8.4 8.5 8.6 8.7 8.8

Please initial here

9.

Conditions of Registration All details regarding registration and termination of registration are contained in the appropriate CityVarsity registration documentation, the contents of which are deemed to have been read and understood by the Student hereto. Furthermore, the following terms and conditions are agreed to: The Student’s failure to attend lectures for whatever reason shall in no way entitle him/her to a reduction in fees, nor will it absolve him/her from full liability for the payment of fees and other charges. No cancellation of this contract shall be of force or effect without written consent thereto by an authorized officer of CityVarsity; The right to attend lectures and write examinations is not transferable; The Student hereby accepts that CityVarsity shall have the right to vary the course syllabus at any time, without prior notification and without furnishing reasons therefore. CityVarsity shall further have the right to alter timetables and course commencement dates where necessary; CityVarsity shall have the right at its sole discretion, to cancel tuition in any course or subject initially advertised and offered, on the basis of insufficient demand. CityVarsity further reserves the right to combine classes of a similar academic level and content; Fees payable to CityVarsity comprise the tuition and registration fees applicable to the year of study the Student has enrolled for and do not include notes, books, stationery or other items. Furthermore it shall be the Student’s responsibility to bear the cost of transport and specialised consumables used during the course including but not restricted to specialised stationery, or any other materials; In the case of any event beyond CityVarsity’s control resulting in lectures and/or tuition not being possible, then CityVarsity reserves the right to cease lectures and close the college temporarily. While every effort will be made to resume lectures as soon as possible, no warranties are made in this regard and no refund in fees will be made; No relaxation, variation or indulgence granted by CityVarsity to other signatories hereto in respect of this agreement shall constitute a waiver of any rights vesting in CityVarsity in terms hereof; and no reliance may be placed by the Student or other signatories hereto or any statement or representation not contained herein. 9.9.2 The Student chooses as their domicilium citandi et executandi for all purposes arising herefrom:

9.1 9.2 9.3 9.4 9.5 9.6

9.7

9.8

9.9.1 CityVarsity chooses as its domicilium citandi et executandi for all purposes arising herefrom:

__________________________________________________________ __________________________________________________________ __________________________________________________________

___________________________________________________________ ___________________________________________________________ ___________________________________________________________

9.10 In the event of the signatories to this agreement, other than CityVarsity, having completed this form incorrectly, or the payment details herein not being in accordance with the requirements of CityVarsity, then such incorrect information or payment details shall be deemed to have been amended so as to be in accordance with the requirements of CityVarsity, without further notice. 9.11 CityVarsity shall be deemed to include any division of CityVarsity or any other juristic person to whom the rights and obligations of CityVarsity, as contained herein may be ceded and/or assigned. 9.12 Documentation required for registration must include but is not limited to; (i) Original or certified copy of Matriculation Certificate or symbols. If awaiting matriculation results, these must be furnished as soon as they become available; (ii) Academic record and certificate of good conduct should the applicant be transferring from another college or examining body to CityVarsity. This registration will only be considered once the registration form is duly completed, the correct documentation is attached and submitted, with proof of payment of the required registration fee, to the CityVarsity Registrar. Please do not hesitate to contact CityVarsity should you have any queries regarding the completion of this form.

Please initial here

10.

TO BE COMPLETED IN THE CASE OF AN APPLICANT WHO IS A MINOR, I.E. UNDER THE AGE OF 18.

I, the undersigned applicant, duly assisted as far as in law need be by (full name of parent/legal guardian) in his/her capacity as my parent/legal guardian do hereby:

10.1 acknowledge that I understand the provisions of the declarations of indemnity above and hold myself bound thereby and by all other provisions in this registration; and by the Rules and Procedures of CityVarsity for the time being in force or as they may be altered, for any period during which I am a registered Student: 10.2 declare that I know that, should I during my attendance at CityVarsity undergo training in any lecture theatre, workshop, studio or any other place of training or attend any excursion, event or sporting activity whether within or without CityVarsity, I may be exposed to risks to life, or to bodily injury, or to health or illness or of damage to property, or personal liability therefore and that in the full knowledge of this, I consent to run all the risks involved in such training, excursion, exercise, event or sporting activity. Furthermore I acknowledge that the cost of transport to and from such training, excursion, exercise, event or sporting activity shall be for my account; 10.3 acknowledge that I have familiarised myself with this contract, and certify that the information given in this form is accurate and complete in all respects; 10.4 acknowledge that I am aware that CityVarsity is not a university and as such does not award any degrees; 10.5 acknowledge that I am aware that I have to satisfy the requirements of due performance as laid down by CityVarsity; 10.6 hold myself responsible for the payment in full of all fees and other charges as and when they fall due for payment at CityVarsity; 10.7 agree that where tuition fees are payable to CityVarsity in installments, the failure to pay any single installment timeously will result in the full balance becoming immediately due and payable without further notice; 10.8 agree that CityVarsity shall be entitled to recover from me all legal costs incurred by CityVarsity in order to enforce its rights under this contract, including, but not by way of limitation, attorney and own client fees and collection charges and all tracing charges. and I, (full name of parent/legal guardian) in my capacity as the above parent/legal guardian do hereby:

10.9 assist the Student Applicant in all respect in making this registration and hold him/her and myself bound by all the provisions thereof and by the rules and regulations of CityVarsity for the time being in force or as they may be altered; 10.10 consent to the Student Applicant attending CityVarsity subject to the provisions of the registration; 10.11 certify that the information given on this form is accurate and complete in all respects; 10.12 hold myself jointly and severally responsible as co-debtor, together with the applicant, for the full payment of all fees and charges as and when they fall due for payment at CityVarsity; 10.13 confirm that I have read and understood the terms and conditions of the Enrolment Contract, and agree to be bound by them; 10.14 agree that where tuition fees are payable to CtiyVarsity in installments, the failure to pay any single installment timeously will result in the full balance, becoming immediately due and payable without further notice; 10.15 agree that CityVarsity shall be entitled to recover from me all legal costs incurred by CityVarsity in order to enforce its rights under this contract, including, but not by way of limitation, attorney and own client fees and collection charges and all tracing charges.

Signature of Student Applicant

Date

Signature of Parent/Legal Guardian

Date

11. TO BE COMPLETED IN THE CASE OF AN APPLICANT WHO IS NOT A MINOR, I.E. AGED 18, OR OVER I, (full name) 11.1 the undersigned applicant do hereby:

11.2

11.3 11.4 11.5 11.6 11.7 11.8 11.9

declare and warrant that I am a major and have full capacity to act; acknowledge that I understand the provisions of the declarations of indemnity above and hold myself bound thereby; and by all other provisions of this registration and by the rules and procedures of CityVarsity for the time being in force or as they may be altered, for any period during which I am a registered Student: declare that I know that, should I during my attendance at CityVarsity (Pty) Ltd undergo training in any lecture theatre, workshop, studio or any other place of training or attend any excursion, exercise, event or sporting activity whether within or without CityVarsity, I may be exposed to risks to life, or to bodily injury, or to health or illness or of damage to property, or personal liability therefore, and that in the full knowledge of this, I consent run all the risks involved in any such training, excursion, exercise, event or sporting activity. Furthermore I acknowledge that the cost of transport to and from such training, excursion, event, exercise, or sporting activity shall be for my account; acknowledge that I have familiarised myself with this contract, and certify that the information given in this form is accurate and complete in all respects; acknowledge that I am aware that CityVarsity is not a university and as such does not award any degrees; acknowledge that I am aware that I have to satisfy the requirements of due performance as laid down by CityVarsity hold myself responsible for the payment in full of all fees and other charges as and when they fall due for payment at CityVarsity; confirm that I have read and understood the terms and conditions of this contract and agree to be bound by them; agree that where tuition fees are payable to CityVarsity in installments, the failure to pay any single installment timeously will result in the full balance, becoming immediately due and payable without further notice; agree that CityVarsity shall be entitled to recover from me all legal costs incurred by CityVarsity in order to enforce its rights under this contract, including, but not by way of limitation, attorney and own client fees and collection charges and all tracing charges.

Signature of Student Applicant

Date

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