DSAR 01

For office use only:

APPLICATION TO STUDY
AT UNISA
INSTRUCTIONS:
• Please complete this form in black ink.
• This application form is for NEW students intending to apply for undergraduate or postgraduate formal studies.
• Unisa will send you a reference number by e-mail, SMS or mail after the form has been processed.
• Refer to the Your choice @ Unisa booklet and pages 3 and 4 of this application form for the applicable codes.
• Please note that the application fee (R150,00) is non-refundable. NB: Unisa does not accept cash or cheques.
• Your application will only be finalised on receipt of supporting documents (see the Your choice @ Unisa booklet) and the non-
refundable application fee. Note: The university reserves the right to request original educational qualifications.
• CLOSING DATES MUST BE ADHERED TO.

1. a) Proposed qualification (eg BCom) 1. b) Specialisation

2. Qualification code (eg 02011)

3. Surname

4. Initials 5. Title

6. Full name

7. Maiden name and/or previous surname (if applicable)

8. Date of birth D D M M Y Y Y Y 9. Gender (mark with an X) Male Female

10. Language of correspondence (mark with an X) Afrikaans English

11. Identity (RSA) or passport number (foreigners)

12. a) Do you have a disability? Yes No 12. b) Nature of your disability (see codes)

13. Telephone numbers Home Contact number for courier

(dialling code & number) Work Cell (format +27 83 111111)
(eg 011 839 4671 x2769) E-mail Fax

Address for personal delivery from Unisa

14. Postal address and postal code Physical address and postal code (eg courier of study material during office hours)

Postal code Postal code Postal code

15. Examination centre code (please refer to the Your choice @ UNISA booklet)
16. Home language 17. Nationality

18. Population group for statistical purposes (mark with an X) African Coloured Indian White Other
19. Occupation (code) 20. Economic sector (code)

21. Do you intend applying for financial aid? (mark with an X) No NSFAS (RSA only) Eduloan
Applications Office:
PO Box 1
Unisarand
0148
Tel: 086 1670 411 or +27 11 670 9000
Fax: 012 429 8116
22. After you have worked through Your choice @ Unisa, do you require further assistance with career planning Yes No
and the appropriate selection of a study programme and subjects? (mark with an X)
23. May your name and contact details be given to fellow students for academic purposes? (mark with an X) Yes No
24. School leaving particulars:
Type of certificate (mark with an X)

Senior Certificate National Senior Certificate (NSC) from 2008 Current Grade 12

Other (please specify, such as O-levels) _______________________________________________________________________

Result achieved (mark with an X) 
Std 10/Grade 12 with full exemption Std10/Grade 12 without exemption
NSC entry-level bachelor's degree NSC entry-level diploma
NSC entry-level Higher Certificate Did not pass Std 10/Grade 12
Other (please specify eg O-levels)

25. Examination number (RSA applicants) 26. Year completed (RSA applicants)

27. Province (RSA applicants)

Give particulars of last tertiary institution at which you were registered before 2009:

28. Institution (eg University of Cape Town)

29. Last year of registration

30. a) Indicate undergraduate or postgraduate b) Name of qualification

31. Do you intend applying for course exemptions/credits from previous studies? (mark with an X) Yes No

32. If yes, indicate student number from other institution

33. Do you need training in basic computer skills? (mark with an X) Yes No

34. Do you have access to the following? Internet Cellphone CD Rom DVD Rom MP3 Player
(mark with an X) (on a computer) (on a computer)

I declare that all the particulars furnished by me on this form are true and correct. I undertake to comply with all the rules, regulations
and decisions of the university and any amendments thereto, and I have taken note of advice which may be applicable to students in
general.

Surname: ______________________________________ First names: ________________________________________

Applicant's signature: _______________________________________ Date: ______________________________________

PAYMENT CAN BE MADE IN ONE OF THE FOLLOWING WAYS:
NATIONAL APPLICANTS: Postal order, credit card.
When applying online, application payment can be made at www.unisa.ac.za
INTERNATIONAL APPLICANTS: Credit card or SWIFT. Attach proof of payment when using SWIFT.

CREDIT CARD PAYMENT

C/card no
If payment is on budget, mark
Expiry date M M Y Y Y Y 6 12 18 24 36
period in months with √
a) Card holder: identity number

b) Card holder: surname & initials

c) CV number (last three digits on d) Signature

the back of the card)

…………………………………………………………………………………………………………………………………………………
CHECKLIST FOR APPLICATION
Items that must be submitted before your application will be processed:
Application form (which you must submit using the pre-addressed envelope)
A certified copy of school qualifications (eg Senior Certificate)
A certified copy of all tertiary qualification(s), academic record and conduct certificate (where applicable)
A certified copy of ID document (RSA students) or passport/birth certificate (foreign students)
A certified copy of marriage certificate (where applicable) or divorce order (where applicable)
Application fee (R150,00)
Original official translations of document(s) if they are not in English or Afrikaans

APPLICATION DATES AND FEES:

Category Opens Closes Fees
Semester 1, year modules, Hons, 1 July 2009 16 October 2009 R150,00
BTech and structured Masters
Semester 2 15 March 2010 30 April 2010 R150,00
Research Master’s and doctoral 1 July 2009 30 June 2010 R150,00
degrees

CODES:
A) DISABILITY CODES (for question 12)
CODE DISABILITY CODE DISABILITY
02 Visually impaired: blind 13 Muscular/skeletal/joint/limb deficiencies/diseases,
such as polio or muscular dystrophy
03 Visually impaired: not blind. Find it difficult to read 14 Other neurological diseases, such as multiple sclerosis
printed text. CANNOT study through reading. Need help
in the form of audio cassettes, enlarged print or
computer discs for computers with voice synthesizers
04 Visually impaired: not blind. CAN study through reading. 15 Cardiovascular diseases, such as heart disease or
Do not need study material on audio cassette blood pressure
05 Hearing disability: study material on audio cassette 16 Kidney and blood deficiencies
should be transcribed
06 Deaf 17 Stroke/brain disorders
07 Dyslexia and other similar learning disabilities 18 Mental health problems/mental
disorders/phobias/chemical imbalances
08 Communication and speech problems, such as stuttering 19 Diabetes
09 Cerebral palsied 20 Serious chronic diseases
10 Paraplegic 21 Multiple disabilities
11 Quadriplegic 22 Disabilities not mentioned
12 Epilepsy 23 In a wheelchair
B) OCCUPATION (for question 19):
CODE OCCUPATION CODE OCCUPATION
01015 Accountant/auditor 01279 Technical worker (other)
01023 Architect/quantity surveyor 02003 Manager/administrator
01031 Computer specialist 0300X Sales worker
0104X Engineer 04006 Clerical or related worker
01058 Farm management advisor 05002 Craftsman/including craftswoman or related worker
01066 Forester/conservationist 06009 Operator (except transport)
01074 Home management advisor 07005 Operative (transport)
01082 Jurist 08001 Labourer (except farm)
01090 Librarian/archivist 09008 Farmer/farm manager
01104 Mathematician 10006 Farm labourer/farm foreman
01112 Life/physical scientist 11010 Prison service worker
01120 Ops research/systems analyst 11029 Firefighter
01139 Personnel officer 11037 Police officer/detective
01147 Medical doctor/dentist, etc 11045 Citizen force member
01155 Nurse, dietician, etc 11053 Permanent force member
01163 Health technologist/technician 11061 National service trainee
01171 Religious worker 1107X Protection service (other)
0118X Social scientist 11088 Service worker (other)
01198 Social/recreation worker 12009 Housewife
01201 Lecturer/professor 13013 Full-time student at Unisa
0121X Teacher (primary/secondary) 13021 Full-time student (elsewhere)
01228 Engineering/science technician 14001 Occupation not classified
01236 Technician (other) 15008 Unemployed
01244 Vocational counsellor 16004 Retired
01252 Writer/artist/musician 17000 Occupation unknown

01260 Research worker not classified

C) ECONOMIC SECTOR (for question 20)

CODE ECONOMIC SECTOR CODE ECONOMIC SECTOR
01007 Agriculture, forestry and fisheries 02003 Mining
08001 Business and repair services 01236 Other technicians

0300X Construction 09008 Personal services, including hotel and household

services
11215 Education: primary or pre-primary 11401 Professional and related services NOT listed elsewhere
11223 Education: secondary 11509 Public administration: public service, provincial
administration, city councils, municipalities, and so on
11231 Education: tertiary 05002 Transportation, communication and other public utilities
10006 Entertainment and recreational services 11304 Welfare and non-profit membership organisations
07005 Finance, insurance and real estate 06009 Wholesale and retail trade
1110X Hospital and health services 11606 Not applicable (any sector not mentioned above, such as
housewives, pensioners or unemployed)
04006 Manufacturing