Application Form Stellenbosch Hair Academy Application Form NB: Please complete all fields. Course Name: Hairdressing Full TimePart Time Student details Title Student Surname Student Name ID / Passport number Date of birth Nationality Gender MaleFemale Home Language (Please note that all classes will be conducted in English) Ethnic Group BlackEuropeanColouredIndianAsianOther Study Visa YesNo (International students will receive additional information to facilitate their visa application) Student contact numbers E-Mail Address Residential Address Postal Address Parent / Legal Guardian / Spouse Details Title Surname Name ID / Passport number Date of birth Parent / Legal Guardian Contact numbers E-Mail Address Residential Address Postal Address Accommodation Private / Hostel Do you require accommodation? YesNo A list of accommodations will be sent after Application is received. Visit www.stellenboschhairacademy.co.za Education Current / Grade / Level / Highest Qualification Current/ Year Completed School Name of last School attended Where did you hear about Stellenbosch Hair Academy? Friend/FamilyWebsiteInternetFacebookInstagramMagazineNewspaperExhibitionSchoolRadioOther If Other, please specify Medical Disability NoneYes If Yes, please specify Kindly note that all students will be required to undergo a medical examination in order to confirm general state of health. Documentation will be sent as soon as application form has been received. All students will be liable for their own personal medical insurance. International Students: Please ensure that adequate medical insurance has been provided for, prior to arrival in South Africa. Finance Each student will receive a comprehensive information brochure regarding costs, payment options and reservation fees for courses in advance. All students will be required to undersign a formal Legal Contract following acceptance at Stellenbosch Hair Academy. Responsible Person for Payment of Course Fees Title Surname Name ID / Passport number Contact numbers E-Mail Address Residential Address Postal Address Relationship to Student Student Declaration Upon approval of my application, I hereby declare that: 1. All information provided by me on this form to be true and correct; 2. I will acquaint myself with the Rules and Regulations, including the Disciplinary Rules and Procedures of Stellenbosch Hair Academy and will abide by them at all times; 3. I waive any claim against Stellenbosch Hair Academy resulting from any act or omission on my part during tuition, sport, tours, seminars, practical’s or provided residence; 4. I accept full responsibility for the care and safekeeping of all Stellenbosch Hair Academy property (including but not restricted to: books, notes, tools and equipment) issued to me for my training; 5. I will inform Stellenbosch Hair Academy immediately (in writing), in the event of the following: change of residential or postal address, cancellation of or changes made to my course and/or my subjects; 6. I am aware that the validity of my enrolment will be subject to the compliance of the relevant regulations as stipulated by Stellenbosch Hair Academy, notwithstanding provisional acceptance of my enrolment by the Academy; 7. I am aware that fees and legal costs will be recovered from me in the event of failing to fulfil my financial commitments towards Stellenbosch Hair Academy timeously; 8. I accept full responsibility of and liability for the payment of all class tuition, practical and equipment fees as well as other fees determined by Stellenbosch Hair Academy at the date of enrolment; 9. I am aware that Stellenbosch Hair Academy will levy bank and administrative fees as determined by Stellenbosch Hair Academy on all dishonoured cheques or failed debit orders executed by my bank; 10. I will not claim any compensation whatsoever for photos taken (including but not limited to) voices used, student participation at functions and accept that any photos used for publicity purposes will remain the property of Stellenbosch Hair Academy. INDEMNITY FORM Stellenbosch Hair Academy Practical Training & Excursions (including off-site work experience) I, the undersigned, hereby further declare that I shall not institute any claims of any nature whatsoever against Stellenbosch Hair Academy or any employee of Stellenbosch Hair Academy, who is acting within his or her employment capacity, nor shall I in any way whatsoever hold Stellenbosch Hair Academy responsible for any loss or damage I may suffer in person or in respect of any property of mine or which may directly or indirectly arise from my commitment, as a registered student, towards Stellenbosch Hair Academy, with regard to the journey to and from all practical training, excursions and off-site work experience and with regard to any activities pertaining to said-excursions, off-site work experience or in a practical training venue of Stellenbosch Hair Academy, regardless of the way in which such loss or damage may occur and regardless of whosoever or whatsoever may be responsible therefore. I also undertake full participation in all prescribed compulsory activities (upon my own responsibility) voluntarily accepting any risk pertaining to such activities. I hereby confirm that I have duly acquainted myself with the content of all information and rules regarding practical training and orientation (induction), and that I am, as a registered student of Stellenbosch Hair Academy, bound to adhere to the General Rules and Regulations of Stellenbosch Hair Academy. I further declare that, in case I am injured to such an extent thereby rendering me unable to personally grant consent for medical treatment or any other essential medical intervention, the supervisory staff may undersign the necessary documents of consent on my behalf. I also accept full responsibility to acquire my own medical aid and the costs incurred for any medical treatment. To the best of my knowledge, I do not suffer from any physical disability or illness which may inhibit my attendance of any practical training or off-site work experience in any way. I do, however, wish to bring the following to your attention: Medical condition: I am capable of concluding an agreement and am legally competent to sign this application and therefore enter into an agreement with Stellenbosch Hair Academy independently.I undersign this application and enter into an agreement with Stellenbosch Hair Academy with the permission of my parents/ legal guardian/ spouse/sponsor. Application Documentation Please attach the following documentation to Application form: Certified Copy of ID document / Passport Certified Copy of Last School Report / Certificate Proof of Residential Address Short CV Adult learners – proof of Employment History I, hereby declare that all the information provided is complete and accurate to the best of my knowledge I hereby accept all terms and conditions on this application
