PINETOWN GIRLS' HIGH SCHOOL - Pinetown Girls' High School
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PINETOWN GIRLS’ HIGH SCHOOL
136 Josiah Gumede Road, Pinetown, 3610, South Africa
P O Box 1153, Pinetown, 3600, South Africa
Tel: 031-701 1394 Fax: 031-702 8501
E-mail: pghsadmin@pghs.co.za
DATE ISSUED: __ _____
DATE RETURNED: _________________
PARENT’S SIGNATURE: ____________
RECEIVED BY: ____________________
2022
APPLICATION FOR ADMISSION
(TO BE COMPLETED BY BOTH PARENTS/LEGAL GUARDIANS)
1. For a learner to be eligible for admission to this school she must comply with the admissions criteria
as determined by the Governing Body.
2. Admission will not be finalised until all the relevant documentation has been received by the School.
3. If any facts reflected in this application form prove to be incorrect, the School reserves the right to
reject the application, whether or not the application has been previously accepted. It is an offence to
make a false statement about any item pertinent to this application, such as the age and identity of a
child, place of residence, guardianship or previous academic achievement. The members of the
School Governing Body reserves the right to verify any document or statement made in this
application.
4. By making this application for admission to the School, the learner and her parents accept that on
such admission, the learner will be bound by the Code of Conduct and Regulations of the School
throughout the learner’s stay at the School.
5. This form must be completed in full by the applicant’s parent/s or legal guardian.
6. Parent as defined in S.A. Schools Act, No 84 of 1996 is –
a. The parent or legal guardian of a learner;
b. The person legally entitled to custody of a learner; or
c. The person who undertakes to fulfil the obligations of a person referred to in paragraph (a) and
(b) towards the learner’s education at school.
7. Pinetown Girls’ High School is a fee paying school (compulsory school fees);
8. NO AFFIDAVITS WILL BE ACCEPTED.
9. Closing date for applications: 12:00 MIDDAY – 13 AUGUST 2021
Please note new date for closing of applications. No hard copies will be accepted. Please email
application to pghsadmin2@pghs.co.za
10. Submission of an Application Form IS NOT A GUARANTEE that the applicant has been/or will be
awarded a place, and should in no way be construed as an expectation of a place in the School.
11. Learners CANNOT move into the area to live with other people in order to gain admission to this
school.
12. The setting up of boarding accommodation to provide a local address to gain entry to the school is
NOT permitted.
The SGB reserves the right to verify any documents submitted.
LEARNER’S SURNAME: ________________________________________________
LEARNER’S FIRST NAMES: ________________________________________________
GRADE APPLIED FOR: _______________
PRESENT SCHOOL: ________________________________________________NB: This application will only be processed once all relevant
documentation has been received. The following documents (original
and certified copies) must be submitted with Application:
FOR OFFICE USE ONLY
1 Unabridged Birth Certificate.
2 Report – End of School year 2020 and latest
(Term 1 & once Term 2 2021 has been received
must be brought into the school)
3 Both Parents’ ID
4 Guardianship (copy of Court Ruling)
5 Where the residential properties are bonded or
are freehold, copies of rates AND electricity /
water accounts must be attached to verify the
residential addresses stated
6 Where the residential properties are leased,
copies of the current signed Lease agreement,
electricity / water and a personal (eg. Cellphone
or clothing) account must be attached to verify
the addresses stated
7 Verification of employment (from the current
employer(s), self-employment (registration) or
unemployment (as confirmed by UI or Dept. of
Labour) for BOTH parents
8 Immunisation (Road to Health) Card
Acceptance1. PARTICULARS OF LEARNER
Surname: …………………………………………………………………………………………………………………………………………………………………………………………….
First Names: ……………………………………………………………………………………………….
Date of Birth: ……………………………………………………………………………………………..
Identity Number: ……………………………………………………………………………………… Citizenship: ……………………………………………………..
Religion: …………………………………………………………………………………………………….. Mother Tongue: …………………………………………….
Residential Address of Learner: ………………………………………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………………………………………………………………..
Learner living with BOTH PARENTS MOTHER FATHER OTHER
If “other”, please state name: ……………………………………………………………………………………………………………………………………………………..
Relationship to Learner:…………………………………………………………………………………………………………………………………………………………………
Immigrant? If yes, state date of entry in South Africa: …………………………………………………………………………………………………
If not South African – Residence Permit Number: …………………………………………………………………………………………………………….
1.1. SCHOLASTIC
Current Grade: …………………………………………………………………………………………………………………………………………………………………………………
Name and Postal address of present (most recent) school: ………………………………………………………………………………
……………………………………………………………………………………………………………………………………………………………………………………………………………
Telephone No: …………………………………………………………………………. Fax No: …………………………………………………………………………………
Number of years at above school: ………………………………………………………………………………………………………………………………………….
List other schools attended (excluding pre-primary schools): ……………………………………………………………………………………
…………………………………………………………………………………………………………………………………………………………………………………………………………………..
Has pupil been expelled from/refused admission to any school? …………………………………………………………………………..
If yes, which school? ………………………………………………………………………………………………………………………………………………………………………
YES NO
Has pupil repeated any grade?
If yes list grade/s and year/s: ……………………………………………………………………………………………………………………………………………………
Afrikaans Zulu
Please indicate with an X whether your daughter will be taking Afrikaans / Zulu
1.2. ASSOCIATION WITH PINETOWN GIRLS’ HIGH SCHOOL
Are there any sisters at this school?
SISTERS: YEAR YEAR
FROM TO
Name …………………………………………………………………………………………………………………………………. ………………… ………………….
Name …………………………………………………………………………………………………………………………………. ………………… …………………2. PARTICULARS OF BIOLOGICAL PARENTS
Particulars of both biological parents are required.
In the case of a deceased parent please indicate this on the form and a certified copy of the Death
Certificate should be included.
FATHER MOTHER
Surname: ……………………………………………………………………… Surname: ……………………………………………………………………………
Maiden Name: …………………………………………………………………
First Names: ………………………………………………………………… First Names: ………………………………………………………………………
Prof/Dr/Mr: …………………………………………………………………… Prof/Dr/Mrs/Miss/Ms: ………………………………………………….
I.D. Number: ……………………………………………………………….. I.D. Number: ……………………………………………………………………
Marital Status: Married/Divorced/Widowed Marital Status: Married/Divorced/Widowed
(Delete whichever not applicable) (Delete whichever not applicable)
Residential Address (Street): Residential Address (Street):
……………………………………………………………………………………………… …………………………………………………………………………………………………..
…………………………………………………………………………………………….. …………………………………………………………………………………………………..
…………………………………………………………………………………………….. …………………………………………………………………………………………………..
Number of years at above address: ……………….. Number of years at above address: ……………………….
Postal Address: Postal Address:
…………………………………………………………………………………………….. …………………………………………………………………………………………………..
…………………………………………………………………………………………….. …………………………………………………………………………………………………..
…………………………………………………………………………………………….. ……………………………………………………………………………………………………
Home Telephone No: ……………………………………………… Home Telephone No: …………………………………………………….
Work Telephone No: ………………………………………………. Work Telephone No: ………………………………………………………
Fax No: …………………………………………………………………………. Fax No: …………………………………………………………………………………
Cellphone No: ……………………………………………………………. Cellphone No: ……………………………………………………………………
e-mail: …………………………………………………………………………… e-mail: …………………………………………………………………………………..
Company Name: Company Name:
…………………………………………………….……………………………………… …………………………………………………………………………………………………….
……………………………………………………………………………………………… …………………………………………………………………………………………………….
…………………………………………………………………………………………….. ……………………………………………………………………………………………………..
Company Address: Company Address:
……………………………………………………………………………………………… ………………………………………………………………..…………………………………
………………………………………………………..…………………………………… ………………………………………………………………….………………………………
……………………………………………………………………………………………… ……………………………………………………………………………………………………
Occupation: …………………………………………………………………… Occupation: ………………………………………………………………………….
No. of years at existing Company: ……………………… No. of years at existing Company: ………………………………3. PARTICULARS OF STEP-PARENTS/LEGAL GUARDIANS (If applicable)
I/We hereby certify that I/we have legal custody and/or guardianship in respect of the above
named learner – copy attached.
Surname: …………………………………………………………………………… Surname: ……………………………………………………………………………….
Maiden Name: …………………………………………………………………….
First Names: ……………………………………………………………………… First Names: …………………………………………………………………………
Prof/Dr/Mr: …………………………………………………………………………. Prof/Dr/Mrs/Miss/Ms: ……………………………………………………….
I.D. Number: ……………………………………………………………………… I.D. Number: …………………………………………………………………………
Relationship to Learner: ……………………………………………… Relationship to Learner: ……………………………………………………
Residential Address (Street): Residential Address (Street):
…………………………………………………………………………………………………… ……………………………………………………………………………………………………..
………………………………………………………………………………………………….. ……………………………………………………………………………………………………..
………………………………………………………………………………………………….. ……………………………………………………………………………………………………..
Number of years at above address: .……………………… Number of years at above address: ………………………….
Postal Address: Postal Address:
…………………………………………………………………………………………………… ……………………………………………………………………………………………………..
…………………………………………………………………………………………………… ……………………………………………………………………………………………………..
Home Telephone No: …………………………………………………… Home Telephone No: …………………………………………………………
Work Telephone No: …………………………………………………… Work Telephone No: ………………………………………………………….
Fax No: ……………………………………………………………………………….. Fax No: …………………………………………………………………………………..
Cellphone No: ………………………………………………………………….. Cellphone No: ……………………………………………………………………….
e-mail: …………………………………………………………………………………. e-mail: …………………………………………………………………………………….
Company Name: Company Name:
…………………………………………………………………………………………………. ……………………………………………………………………………………………………….
Company Address: Company Address:
……………………………………………………………………………………………….. …………………………………………………………………………………………………..
……………………………………………………………………………………………… ……………………………………………………………………………………………………..
………………………………………………………………………………………………….. ………………………………………………………………………………………………………..
Occupation: ……………………………………………………………………… Occupation: …………………………………………………………………………….4. SCHOOL FEES
Public school fees are a statutory duty in terms of the South African Schools Act No. 84 of 1996 (as
amended). These school fees are payable annually in advance at the beginning of each school year and
as such payment is compulsory. However, purely in order to reduce the financial burden on parents, the
school may extend the terms of payment completely at its discretion.
PAYMENT SCHEDULE:
ONE OFF FULL PAYMENT (10% DISCOUNT)
Payment by 31st March 2022 (less the registration fee paid).
MONTHLY DEBIT ORDER PAYMENTS
Payment of 10 monthly Debit Orders (1st, 15th, 25th February to 1st, 15th, 25th November).
MONTHLY PAYMENTS
Paid directly to our bank account.
SPEED POINT MACHINE AVAILABLE AT THE SCHOOL
Who is responsible for payment of school fees? We require proof of court rulings in respect
of divorce. SHOULD THE PERSON RESPONSIBLE FOR THE SCHOOL FEES NOT BE A PARENT, A
SIGNED LETTER OF CONFIRMATION TO THIS EFFECT FROM THE RESPONSIBLE PERSON
SHOULD ACCOMPANY THIS APPLICATION. According to the SA Schools Act of 1996, biological /
adoptive parents are jointly and severally liable for the payment of the school fees irrespective of their
marital status. A school fee commitment form is to be completed annually.
Name: ………………………………………………………………………………………………………………………………………………………………………………………
Address: ………………………………………………………………………………………………………………………………………………………………………………….
I.D. No: ……………………………………………………………………………………………………………………………………………………………………………………
Signature: ………………………………………………………………………………………………………………………………………………………………………………
5. EMERGENCY DETAILS
Name: ……………………………………………………………………………………………………………………………………………………………………………………………….
Address: …………………………………………………………………………………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………………………………………………………………………………………………………
Telephone No: ……………………………………………………………… Cellphone No: …………………………………………………………………………….
6. MEDICAL
Previous illnesses (nature and seriousness), details of disabilities, allergies or other medical
condition that the school should be aware of: …………………………………………………………………………………………………………….
……………………………………………………………………………………………………………………………………………………………………………………………………………….
Medical Aid: ………………………………………………………………………………………………………………………………………………………………………………….
Membership Number: ………………………………………………………………………………………………………………………………………………………………6. MEDICAL (Cont’d)
Main Member’s Name: …………………………………………………………………………………………………………………………………………………………….
Doctor: …………………………………………………………………………………. Telephone No: ……………………………………………………………………
7. DECLARATION
.1. I UNDERTAKE
a. to furnish original, authentic documents as required;
b. to inform the school in writing of any change of address or telephone number;
7.2.. I declare that the information and documents submitted for this application are true and
correct.
7.3. Should this application be successful I undertake
a. to inform the school in writing of any case of infectious illness in my household;
b. to ensure that this child attends school regularly and to give reasons in writing should my child
be absent;
c. to ensure that this child complies with the code of conduct and regulations of the school;
d. to respect the tradition and character of the school and encourage my child to do the same;
e. to ensure that this child attends organised school activities;
f. to pay the full school fees in terms of Section 39 and 40 of the South African Schools’ Act, Act
No. 84 of 1996;
g. We acknowledge debt of School fees in terms of sections 39 and 40 of the South African
Schools’ Act, Act No. 84 of 1996, and that such fees become due and payable on the first day
of each school year for the duration that my daughter/guardian is a registered learner at
Pinetown Girls' High School. Should school fees not be paid the amount may be recovered by
legal action with costs to the debtor on the attorney/client scale and I, the parent/guardian will
be blacklisted with the Credit Bureau.
h. to pay all costs incurred for damage done or losses caused by my child/ward to school
property.
7.4. I agree that the Principal or her designates may act in loco parentis in the event of any
injury or accident in which my child/ward may be involved.
7.5 I am aware of the option to take out Learners’ Personal Accident Insurance for accidental injury on
school premises and will contact the school for more information.
7.6 I am aware that images of my child may be used from time to time for purposes of school
marketing.
7.7 Ensure that all appointments are made after school hours excepting urgent, valid, specialist
appointments. Letters requesting these urgent appointments are to be forwarded at leas the day
before, for the Principal’s attention.
PARENT/LEGAL GUARDIAN
MOTHER: _______________________________________________________________
SIGNATURE: __________________________________ Date: __________________
FATHER: _______________________________________________________________
SIGNATURE: __________________________________ Date: __________________
GUARDIAN (If applicable): ________________________________________________
SIGNATURE: __________________________________ Date: __________________
N.B. PINETOWN GIRLS’ HIGH SCHOOL IS A FEE PAYING SCHOOL.8. You will be notified in writing as to whether or not your daughter has been
accepted.
An admission fee of R4 000 (R3 800 deducted from 2022 school fund and
R200 administrative fee) is then payable to confirm her enrolment after which
ten equal instalments starting from February to November.
Once a learner has been accepted at Pinetown Girls’ High School:
• a letter to this effect will be emailed to the parents.
• The parents and learner accepts that they will abide by the School’s Code of Conduct and
other policies.
Any other learners applying and living outside the Pinetown area will be considered after learners who
have complied with the Admission Policy. As Pinetown Girls’ cannot guarantee a place at the school it
is advised that parents MUST apply at alternative schools.
• Learners whose closest State High School is NOT Pinetown Girls’ High e.g. Chatsworth,
Hammarsdale (Mpumalanga), Hillcrest, KwaMashu, Newlands, Queensburgh, Umlazi,
Waterfall, etc., must apply for admission to schools closer to their homes.
9. WITNESS – A CONTACT PERSON NOT LIVING WITH YOU
NAME: ___________________________________________
ADDRESS:______________________________________________________________________
________________________________________________________________________________
TEL. NO: _________________________________ SIGNATURE: ________________________
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