1. PERSONAL INFORMATION
GENERAL
Application for admission for the year in which you want to commence your studies:

Course:
---Occupational Certificate: Tourist Information Officer, SAQA ID: 101865Bookkeeping NQF 4Occupational Certificate: Training and Development Practitioner, SAQA ID: 101321Occupational Certificate: Safety, Health and Quality Practitioner (Occupational Health and Safety Practitioner), SAQA ID: 99714Occupational Certificate: Computer Technician, SAQA ID: 101408

Gender: ---MaleFemale

Where did you hear about ATTI?
---SchoolCareer ExhibitionInternetFriendsRadio/Press

Home Language:
---AfrikaansEnglishIsindebeleIsixhosaIsizuluSesothoSetswanaSiswati

Population group:
---WhiteIndianColouredBlack

APPLICANT: PERSONAL INFORMATION

Title (example Mr/Ms/Miss/Mrs):

Surname

First names in full:

Name:

ID Number

Cellphone number

Postal Address

Code

Residential Address


Code

Email Address

DETAILS REGARDING SCHOOL EDUCATION

School Name:

Town/city in which school is situated:

Grade 12 year:

Please list Grade 12 subjects and symbols achieved:
Subject 1
Subject 2
Subject 3
Subject 4
Subject 5
Subject 6
Subject 7
Subject 8

INFORMATION OF PARENT / GUARDIAN

Title (example Mr/Ms/Miss/Mrs):

Relationship:

Surname:

Full names:

ID number:

Cell phone number:

Home Telephone:

Work Telephone:

Fax number:

Postal Address:

Code

Residential Address:

Code

E-mail Address

Employer:

Occupation:

Work address:

Code

INFORMATION OF PERSON RESPONSIBLE FOR PAYMENT OF ACCOUNT
Same As Above

Title (example Mr/Ms/Miss/Mrs):

Relationship:

Surname:

Full names:

ID number:

Cell phone number:

Home Telephone:

Work Telephone:

Fax number:

Postal Address:

Code

Residential Address:

Code

E-mail address:

Employer:

Occupation:

Work address:

Code

DECLARATION

I declare that all the information provided by me in this form is true and accurate. I undertake to comply with all the rules, regulations and decisions of ATTI and the Centre, and any amendments thereto, which may be applicable to students in general and to the programme for which I am registered. I understand my responsibility to pay the study fees involved in these programmes as specified at specific times. I also understand that ATTI retains the right to refuse, revoke or cancel any registration.

I furthermore understand that no party-political activity will be tolerated on ATTI property and that should I engage in such activity or make myself guilty of engaging in student unrest, action suitable to the misconduct, might be taken against me, which can include, but not be limited to, being expelled from ATTI premises and legal steps being taken.
I hereby further declare that I have made myself familiar with the set Policies and Procedures of the ICB and that these policies are fully understood by me and that I submit and subject myself to these policies that might also be updated from time to time by the ICB.

ATTI NELSPRUIT REGISTRATION FACTS

Provisionally Registered by the Department of Higher Education and Training as a Private FET College. Reg No: 2010/FE07/058 until 31 December 2019.
Full Accreditation by MICT SETA. Accreditation Number: ACC/2005/08/213
ICB Provider Accreditation number: 300723

Signed at Nelspruit on this

day of

Year

Full name and surname

ID

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