FORM 3A

CERTIFICATE FOR LEARNERS OR STUDENTS TO TRAVEL TO ANOTHER PROVINCE/METROPOLITAN

AREA/DISTRICT
Regulation 34 (5)
This certificate must be presented together with an identity document/driver's licence of the learner/student to whom this is issued.

Valid for 2021 Academic Year

I,

Surname MASEKO
Full Names PAMELA
Name of Institution Nelson Mandela University
Address of Institution University Way
Summerstrand
Port Elizabeth

Province of Institution Eastern Cape

Metropolitan area/district of Port Elizabeth
Institution
Contact Details Cell Tel (W) Tel (H) Email Address
0415041111 0415041111 0415041111 pamela.maseko@mandela.ac.za

In my capacity as Head/delegated person of above mentioned school/institution, hereby declare that the under mentioned learner/student, is a
learner/student at this school/institution, and needs to travel between different provinces/metropolitan areas/districts for education.

Student Surname SUMMERTON

Student Full Names CHESTER NTSIKA ANATHI
Student Residential Address 3658 NU8
MDANTSANE
EAST LONDON

Province of Residence EASTERN CAPE

Metropolitan area/district of EAST LONDON
Residence
Full Name of Primary Care Giver
Student Contact Details Cell Tel (W) Tel (H) Email Address
0651857206 0824573579 0783956974 s218164742@mandela.ac.za

Signed at Port Elizabeth on this the 3rd day of March 2021

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