Learner Registration Form – Syllabis Education Solutions

Parent / Guardian / Sponsor Full Name *

First

Last

Parent ID

Home Address

Mobile Number

Email *

Student Full Name

ID Number

Date of Birth

Gender

Age

Last School Attended

Last Grade Passed

Current Grade

Proposed Grade

Grade 10 - 12 Subject Choices (Select 4 compulsory subjects)

Grade 10 - 12 Subject Choices (Select 3 elective subjects)

Other Subjects

If your elective subjects not listed above, please list them here.

eBooks / Textbooks

Students Valid ID Copy

Click or drag a file to this area to upload.

Please upload a copy of your childs ID Document.

Signature *

Please sign on the space provided. By signing this document you certify that the information provided is correct and you accept the above terms and conditions.

Please Invoice Me

Yes

Payment Terms

Cash Payment with Discount
Payment Plan

Payment Method

EFT
Credit / Debit Card
Cash Deposit

Syllabis Representative

Which Syllabis representative did you deal with.