BENONI HIGH SCHOOL Learners Photo

Tel : 011-849-4129 Fax : 011-425-1800

LEARNER INFORMATION
ALL SECTIONS on the application must be completed in full and in
block letters. Incomplete information will result in a delay in
processing this application
FOR OFFICIAL USE APPLYING FOR GRADE
Date received
Admission No 8,9,10,11
Account No Year

Note: withholding or false declaration of information will nullify any decision of admission to this school.
If we cannot contact you at the address/telephone numbers supplied, this application will be cancelled.
LEARNER DETAILS

Learner's Surname :

Learner's Names - as per Birth Certificate

Identity Number : Race Gender Religion

Learner resides with : Mother Father Guardian Both Parents Other: _________________

Physical address :

(where learner lives )

Home Language : Other Language :

South African YES If NO - Country of birth

Citizen NO Immigration date

IS BENONI HIGH THE NEAREST SCHOOL TO YOUR HOME ? YES NO

Present Grade Name of School

School Address

School Tel. No. Fax No.

PARENT / GUARDIAN DETAILS

PARENT / GUARDIAN 1 PARENT / GUARDIAN 2

Surname Surname

Name Name

Title Title

Relationship to learner Relationship to learner

Residential Address Residential Address

(chosen domicilium ) (chosen domicilium )

Postal Code Postal Code

Postal Address Postal Address

Postal Code Postal Code

ID Number ID Number

Employer Employer

Occupation Occupation

Phone (w) Phone (w)

Address of Employer Address of Employer

Postal Code Postal Code

E mail address E mail address

Phone (h) Phone (h)

Cell No,. Cell No,.

Marital Status Marital Status

Reason why learner resides with guardian

MEDICAL DETAILS
Name of Medical Aid

Disabilities or Allergies Medical Aid No.

Main Member Details

Emergency Contact Name Relationship

other than parents Tel/Cell No. to learner

 Please give details of who is responsible for fees if there are no biological parents
Surname

Name

Title

Residential Address

Postal Code

Postal Address

Postal Code

ID Number

Employer

Occupation

Phone (w)

Fax No.

Phone (h)

Cell No.

Email Address

Relationship to learner

Parents deceased? Mother Father

Fees paid by Trust :

Name of Trust

Contact Person

Tel. Nr :

Name of ALL school-going learners for whom you are

responsible - including brothers and sisters attending BHS
Name School Grade Relationship to learner

SUBJECT CHOICE:
Grade 8 and 9 - All subjects are compulsory

Grade 10-11 (only) - Subjects must be chosen from the subject sets offered by the school which are available on the school's website at
www.bhs.co.za. Subject sets are dependent on available space and may change from time to time. Please indicate below which subject
set you wish to choose:

Subject set chosen: __________________________

This application must be accompanied by:

1. One certified copy of Learner's birth certificate and/or ID book/card
2. One ID photo of learner to be glued on front of this form
3. Certified copies of both parents or legal guardian/s ID books/cards (proof of legal guardianship must be provided)
4. Proof of residence: EITHER municipal rates account/transfer deeds/rental agreement (NO AFFIDAVIT ACCEPTABLE)
5. If either one or both parents are deceased, certified copy of death certificate is required
6. Grade 8: Final report from Grade 6 as well as latest report from Grade 7
7. Grade 9-11: Final report from previous Grade as well as latest report from current Grade (if applicable)
8. A Curriculum Vitae (see last page)

PLEASE NOTE SCHOOL FEES ARE PAYABLE IN ADVANCE AND THAT THE SCHOOL LOOKS TO
BOTH PARENTS/GUARDIANS FOR PAYMENT OF SCHOOL FEES, IRRESPECTIVE OF WHETHER PARENTS/
GUARDIANS ARE SINGLE, MARRIED, SEPARATED, DIVORCED, REMARRIED, MARRIED CUSTOMARY LAW ETC.

I/We _______________________________________________________ accept full responsibility for payment of school fees.

PARENT / GUARDIAN 1 SIGNATURE PARENT / GUARDIAN 2 SIGNATURE DATE

I/We declare that the above particulars are true and correct, and that I/we have read and understood the contents.

PARENT / GUARDIAN 1 SIGNATURE PARENT / GUARDIAN 2 SIGNATURE DATE

 DECLARATION AND UNDERTAKING – PARENT/GUARDIAN
I, ___________________________________________________________ (full names of Parent/Guardian 1)
ID No. __________________________________________ Cell No. _________________________________
Residential (domicilium) address _____________________________________________________________
__________________________________________________________________ Postal Code __________

I, ___________________________________________________________ (full names of Parent/Guardian 2)

ID No. __________________________________________ Cell No. ________________________________
Residential (domicilium) address ____________________________________________________________
__________________________________________________________________ Postal Code __________

Parent/Guardian of ___________________________________________________ (full names of learner)

UNDERTAKE
 To the best of my/our ability, to encourage my child to acquire and adopt good study habits, to provide facilities for him/her to study and
do homework, and check on a regular basis that homework is done as and when required.
 To ensure that care is taken of all the books and equipment that are issued to my child and to return these, on request, in good
condition, and make good any loss or damage.
 To pay for any damage willfully done to the school’s buildings and property by my/our child.
 To ensure that my/our child attends school regularly, is punctual and does not leave early except for good and sufficient reasons.
 To send an explanatory note or medical certificate (only a medical certificate will be accepted for exam/test absence) every time my/our
child is absent from school, and inform the school of any cases of infectious illness in our home.
 To allow my/our child to participate in sports and extramural activities and to provide the required kit.
 I/we accept that my/our child’s first allegiance will be to his/her school team when applicable and not to outside “Club” activities. I/we
understand that under normal circumstances there should be no need for a clash of loyalties.
 That I/we have studied the school Prospectus, in its entirety, which is subject to annual review and available on the school’s website at
www.bhs.co.za or from the front office (on request) and I/we agree to support the school in its endeavors and set aims and accept the
regulations as set out in the Prospectus, and by signing this document I/we subscribe voluntarily to the dictates of said Prospectus and
any other regulations which the Management Council and the Principal may stipulate from time to time.
 To fulfill all financial obligations to the school. If at any time and for any reason I/we am/are unable to do so, to negotiate with the
Governing Body and/or school finance department. I/we consent to pay all legal/debt collection costs on the scale as between attorney
and client, alternatively between debt collector and client, and choose my/our residential address as my/our domicilium citandi et
executandi for legal purposes.
 I/we authorize the school to conduct Credit Bureau searches on me/us on admission information and in the event of any school fees
due by me/us not being paid, I/we authorize the school to inform any relevant credit bureau and have my/our name/s listed with them.
 That in the event that I/we are not the natural parent and or guardian of the learner/s, I/we accept responsibility of parent as defined in
Section 1 of the South African Schools Act.
 To notify the school in writing of any change of address, telephone numbers, cell phone numbers and e-mail address.
 To notify the school in writing if my/our child no longer resides with me/us and advise the name and address of the person with whom
my/our child now resides.

Signed at ____________________________, on this day ___________________________, as acceptance of the above undertaking.

______________________________ ________________ ______________________________ ________________

Parent/Guardian 1 Date Parent/Guardian 2 Date

DECLARATION AND UNDERTAKING – LEARNER

I, ___________________________________________________________ (full names of learner)

UNDERTAKE
 To the best of my ability, acquire and adopt good study habits and to complete homework as and when required.
 To ensure that care is taken of all the books and equipment that are issued to myself and to return these, on request, in good condition,
and make good any loss or damage.
 To ensure that I attend school regularly, be punctual and that I do not leave early except for good and sufficient reasons.
 That I have studied the school Prospectus, in its entirety, which is subject to annual review and available on the school’s website at
www.bhs.co.za or from the front office (on request) and I agree to support the school in its endeavors and set aims and accept the
regulations as set out in the Prospectus, and by signing this document I subscribe voluntarily to the dictates of said Prospectus and any
other regulations which the Management Council and the Principal may stipulate from time to time.

Signed at ____________________________, on this day ___________________________, as acceptance of the above undertaking.

______________________________ ________________
Learner Date
 CURRICULUM VITAE OF STUDENT

TO BE COMPLETED BY STUDENT IN HIS/HER OWN HANDWRITING

PERSONAL DETAILS:

NAME: _____________________________________________________
AGE & DATE OF BIRTH: _____________________________________________________
ADDRESS: _____________________________________________________
_____________________________________________________
TELEPHONE NO’S: _____________________________________________________

EDUCATION:

SCHOOLS ATTENDED: _____________________________________________________

_____________________________________________________

ACADEMIC ACHIEVEMENTS: (Last 2 years only)

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

SPORTS & SPORTING ACHIEVEMENTS: (last 2 years only)

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

SOCIAL ACTIVITIES & ACHIEVEMENTS: (If any – last 2 years only)

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

SPECIAL INTERESTS:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

BRIEFLY OUTLINE THE REASON WHY YOU WOULD LIKE TO ATTEND BENONI HIGH SCHOOL:
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________

PROVIDE A BRIEF DESCRIPTION OF YOUR FAMILY:

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
 BENONI HIGH SCHOOL
Dalrymple Street, Northmead Extension 3, Benoni

Telephone: (011) 849-4129/0 P.O. Box 12202

Fax: (011) 425-1800 Benoryn 1504
E mail address: admin@bhs.co.za web site: www.bhs.co.za

Dear Parents

Set out below is an abridged school fee policy letter that was sent to all parents regarding 2022 school fees.

SCHOOL FEES POLICY 2022

You are hereby notified of the following important matters regarding the payment of school fees.

1. At the Benoni High School Annual General Meeting of the Governing Body held at 18H00 on Tuesday, 16
November 2021, the school fees for 2022 were determined in accordance with resolutions and proposals put forward
and voted on by all parents present and in accordance with Section 39 of the South African School's Act 1996. The
school fees for 2022 are R28 424.00 per learner payable in advance. This figure excludes textbooks/work books,
excursions, extra murals, tours etc. Parents with pupils in Matric in 2022 are requested to settle the school fee account
before 30 September 2022. The school looks to both biological parents for payment of school fees,
irrespective of whether they are divorced, single, remarried, separated, married under customary law etc.

2. All parents are obliged to pay the prescribed school fees in terms of Section 40 of the South African Schools Act,
1996, unless or to the extent they have been exempted from payment. (See paragraph 5)

3. School fees must be paid using one of the following options:

OPTION A ** R 25 582.00: R 28 424.00 less 10% discount (R 2 842.00) if paid on or before 31 December 2021.
OPTION B ** R 27 003.00: R 28 424.00 less 5% discount (R 1 421.00) if paid on or before 31 January 2022.
OPTION C ** R 28 424.00: comprising 11 equal payments of R 2 584.00 commencing on or before
07 January 2022 with the final instalment on or before 30 November 2022.
** Any accounts settled AFTER the above discount dates WILL NOT qualify for a discount.
** Options A & B may be selected if paid by DIRECT DEBIT, ELECTRONIC PAYMENT or DIRECT DEPOSIT
into ABSA Bank. STRICTLY NO CREDIT CARD, CHEQUE OR CASH PAYMENTS WILL BE ACCEPTED
FOR OPTIONS A & B.

Banking Details Benoni High School

BANK ABSA Benoni
Branch Code 632005
Account No 0108 272 0207
Reference No (A school fee account number will be allocated to new pupils. This account no. must
be quoted on all payment transactions relating to school fees. If an account no.
has not yet been allocated and parents wish to pay fees, please quote the pupil’s name
and surname as a reference)
Please forward proof of payment to the school – schoolfees@bhs.co.za

PLEASE NOTE: NO CASH PAYMENTS WILL BE ACCEPTED FOR THE PAYMENT OF SCHOOL FEES AT
THE SCHOOL OFFICE.
SHOULD CASH BE DEPOSITED DIRECTLY INTO THE SCHOOL’S BANK ACCOUNT, THERE WILL BE AN
ADDITIONAL 3.3% (OF THE TOTAL AMOUNT DEPOSITED) ADDED TO THE PARENT’S SCHOOL FEE
ACCOUNT WITH A MINIMUM CHARGE OF R 62.00 PER CASH TRANSACTION.

4. In terms of Section 40 and 41 of the South African Schools Act, the school may enforce the payment of compulsory
school fees.

5. A parent who wishes to apply for exemption from payment of school fees, in full or in part must complete the
prescribed application for assistance form which can be collected from the school fee office at the school.
The cut-off date for exemptions will be the 28th February 2022 for mainstream applications.

Please complete the checklist marked “Annexure G” and return to Benoni High School together with the completed
application form for 2022 enrolment.

Yours sincerely

Dr E Rooyakkers
Principal
 BENONI HIGH SCHOOL
Dalrymple Street, Northmead Extension 3, Benoni

Telephone: (011) 849-4129/0 P.O. Box 12202

Fax: (011) 425-1800 Benoryn 1504
E-mail: vandac@bhs.co.za
Web site: http://www.bhs.co.za

Dear Parents

In order to comply with the LURITS system introduced by the Department of Education, all parents are required to complete
and sign the following form in full. Incomplete forms will be returned back to parents to complete.

The form must be completed and signed by BOTH BIOLOGICAL PARENTS/legal guardians, irrespective of whether the
biological parents are single, married, remarried, divorced, never married etc.

PLEASE COMPLETE THE REQUIRED INFORMATION IN BLOCK LETTERS. Only black or blue pen allowed.

Name of Pupil __________________________________________ Grade ________________

RESIDENTIAL ADDRESS WHERE PUPIL LIVES:

NAME OF COMPLEX: UNIT NUMBER:
STREET NUMBER: NAME OF STREET:
SUBURB/AREA:
TOWN/CITY: POSTAL CODE:
PROVINCE:
POSTAL CODE:

PUPIL LIVES WITH: **IF OTHER STATE:

MOTHER _____ FULL NAMES: ___________________________________________
FATHER _____ ID NO: _____________________ HOME TEL: _____________
OTHER _____ ** WORK TEL: _________________ CELL: _________________
RELATIONSHIP TO PUPIL: ________________________________

EMERCENCY CONTACT DETAILS (OTHER THAN PARENT/GUARDIAN)

FULL NAME:
RELATIONSHIP: GRANDPARENT ____ AUNT/UNCLE ___ FRIEND ___ OTHER (state) ___________
TELEPHONE NO’S: HOME: WORK:
CELL:
(PARENT 1) RELATIONSHIP TO PUPIL: MOTHER / FATHER / OTHER (STATE):
FULL NAMES:
IDENTITY NUMBER:
RESIDENTIAL (DOMICILIUM) ADDRESS OF PARENT 1
NAME OF COMPLEX: UNIT NUMBER:
STREET NUMBER: NAME OF STREET:
SUBURB/AREA:
TOWN/CITY: POSTAL CODE:
PROVINCE:
HOW LONG HAVE YOU LIVED AT THIS ADDRESS? NUMBER OF YEARS ___ NUMBER OF MONTHS ___
TELEPHONE NO’S: HOME: WORK:
CELL: E-MAIL:
POSTAL ADDRESS:
POSTAL CODE:

**PREFERRED METHOD FOR RECEIVING CORRESPONDENCE (SCHOOL FEE STATEMENTS, NEWSLETTERS ETC:
(Mark with an X)

E-mail: If yes, please furnish preferred e-mail address:

E-mail address: _____________________________________

Normal post: If yes, please indicate to which address, postal or residential:

Address: _____________________________________

I CONFIRM THAT THE ABOVE DETAILS ARE TRUE AND CORRECT.

_______________________ _______________
SIGNATURE OF PARENT 1 DATE

(PARENT 2) RELATIONSHIP TO PUPIL: MOTHER / FATHER / OTHER (STATE):

FULL NAMES:
IDENTITY NUMBER:
RESIDENTIAL (DOMICILIUM) ADDRESS OF PARENT 1
NAME OF COMPLEX: UNIT NUMBER:
STREET NUMBER: NAME OF STREET:
SUBURB/AREA:
TOWN/CITY: POSTAL CODE:
PROVINCE:
HOW LONG HAVE YOU LIVED AT THIS ADDRESS? NUMBER OF YEARS ___ NUMBER OF MONTHS ___
TELEPHONE NO’S: HOME: WORK:
CELL: E-MAIL:
POSTAL ADDRESS:
POSTAL CODE:

**PREFERRED METHOD FOR RECEIVING CORRESPONDENCE (SCHOOL FEE STATEMENTS, NEWSLETTERS ETC:
(Mark with an X)

E-mail: If yes, please furnish preferred e-mail address:

E-mail address: _____________________________________

Normal post: If yes, please indicate to which address, postal or residential:

Address: _____________________________________

I CONFIRM THAT THE ABOVE DETAILS ARE TRUE AND CORRECT.

_______________________ _______________
SIGNATURE OF PARENT 2 DATE

Thank you for your co-operation.

Yours sincerely

Dr E Rooyakkers
Principal
 ANNEXURE G (CHECKLIST FORM)
(Mark with a cross in applicable box)

SOUTH AFRICAN SCHOOLS ACT, NO. 84 OF 1996

REGULATIONS FOR THE EXEMPTION OF PARENTS FROM PAYMENT OF SCHOOL FEES
Name of school: BENONI HIGH SCHOOL
EMIS Number: 310151
District: D6 EKURHULENI NORTH

(1) Has the principal informed you about the amount of the annual school fees
to be paid? YES NO

(2) Has the principal informed you that you are liable for the payment of school
fees unless you are totally exempted from paying school fees? YES NO

(3) Has the principal informed you about your right to apply for exemption from
paying school fees? YES NO

(4) Do you wish to apply for such exemption?

YES NO

(5) Do you wish to be assisted in making such application?

YES NO

(6) Has the principal provided you with the form (Annexure B) for application
for exemption? YES NO

DR GE ROOYAKKERS ___________________________________
Name of Headmaster Name of Parent

__________________________ ___________________________________
Signature of Headmaster Signature of Parent

_____________________
Date

____________________________________ ____________
Name of Pupil Grade