FOR OFFICE USE

APPROVED YES NO
WAITING YES NO
BURSARY STUDENT YES NO
STUDENT GROUP
STAFF MEMBER
DATE
APPLICATION FORM
STUDENT NUMBER
(If available)

CAMPUS OF YOUR CHOICE

PRETORIA

ACADEMIC PERIOD

YEAR SEMESTER 1 SEMESTER 2 TRIMESTER 1 TRIMESTER 2 TRIMESTER 3

WERE YOU PREVIOUSLY REGISTERED AS A STUDENT AT CAPE TOWN CITY COLLEGE? YES NO

SURNAME OF STUDENT INITIALS

PROGRAMME / STUDY DIRECTION OF YOUR CHOICE

NATIONAL CERTIFICATE VOCATIONAL (NQF LEVEL 2-4)

OFFICE ADMINISTRATION MARKETING SAFETY IN SOCIETY

HOSPITALITY TOURISM ENGINEERING AND RELATED DESIGN

ELECTRICAL INFRASTRUCTURE CIVIL ENGINEERING AND BUILDING INFORMATION TECHNOLOGY AND

CONSTRUCTION CONSTRUCTION COMPUTER SCIENCE

NATIONAL N-CERTIFICATE (REPORT 191-PROGRAMMES N4-N6)

ELECTRICAL CIVIL MECHANICAL

NATIONAL N-CERTIFICATE (REPORT 191- PROGRAMMES N4-N6)

BUSINESS MANAGEMENT MANAGEMENT ASSISTANT

FINANCIAL MANAGEMENT PUBLIC MANAGEMENT

HUMAN RESOURCE MANAGEMENT MARKETING MANAGEMENT

Please make sure that the course you wish to study is offered at the campus of intended study.

METHOD OF STUDIES

FULL-TIME PART-TIME

EXAM ONLY

GENERAL INFORMATION

Please read the following carefully before completing this form.

A. GENERAL
1. This form must be completed by all students applying to Cape Town City College for the first time.
2. The application form must be signed by the applicant and the legal guardian
(if applicant is younger than 18 years).
3. It is in your own interest to ensure that this form is completed in full and that certified copies of all supporting documentation
are enclosed. If any questions are left unanswered or documents are not enclosed, or the legal undertaking is not signed by
the student and/or the legal guardian, it will cause a delay as the form will be returned for completion.
4. Please write in black ink and use block letters.
5. The closing date for applications will be determined by the College at the start of the respective academic
period or when the programme is full, whichever occurs first.

CTCC-FORM-2022 PAGE 1 OF 7
APPLICATION FORM VALID FROM 30 SEPTEMBER 2022
GENERATOR: STUDENT ADMINISTRATION
B. CERTIFIED DOCUMENTS
1. A certified copy of the first page of your Identity Document must accompany this application.
2. A certified copy of your Senior Certificate (for N4-N6 programmes including City & Guilds programmes) or highest
qualification (for all other NCV and N1-N3 programmes) must be submitted with your application.
3. Grade 12 learners must attach a copy of their Grade 11 final results and June or September Grade 12 results. The report
must indicate the subjects and symbols obtained. If you attended any other higher education institution, an original academic
record or certified copies of other certification obtained previously, must also be submitted.
4. Proof of residential address of parents/guardian or municipal account.

C. INTERNATIONAL STUDENTS (Non South African citizens)

1. A certified copy of your passport must accompany this form.
You are required to produce a valid study permit before you will be permitted to register.
2. Non-RSA qualifications: The onus rests with all international applicants to have their school qualifications evaluated by SAQA
before submitting this application form. SAQA can be contacted on telephone number: +27 86 010 3188.

D. ADMISSION REQUIREMENTS
1. Please consult the faculty concerned or www.bolandcollege.com for full details of the admission requirements pertaining to
the qualification/programme for which you intend to enroll.
2. All candidates who comply with the minimum requirements are still subject to selection procedures determined by the
respective faculty.
3. The Student may be required to complete a placement assessment.

E. PAYMENT POLICY
The various payment options can be considered subject to a credit application and clearance. The minimum amount payable can
be deposited at FNB Bank. In the reference column of the bank deposit, please clearly indicate your student number or identity
number (student) as reference. The financial policy ofCape Town City College does not allow for any deviations from the
prescribed payments.

F. CHANGE OF ADDRESS AND CONTACT DETAIL

The College must be notified immediately of any change of address (postal or physical) after submission of the form.

CTCC-FORM-2022 PAGE 2 OF 7
APPLICATION FORM VALID FROM 30 SEPTEMBER 2022
GENERATOR: STUDENT ADMINISTRATION
SECTION A: PERSONAL DETAILS

Please write one letter per block, starting in the first block. Leave one block open between names. Mark your particulars with an
“x” where appropriate.

SURNAME INITIALS TITLE

MR MS MRS

IDENTITY NUMBER

DATE OF BIRTH Y Y Y Y M M D D

FIRST NAME (1)

SECOND NAME (2)
THIRD NAME (3)

SECTION B: FORMAL STATISTICAL INFORMATION

CITIZENSHIP

100 - RSA 101 - NAMIBIA OTHER (PLEASE SPECIFY)

PASSPORT NUMBER / STUDY PERMIT NUMBER (IF NOT RSA)

IF YOU ARE NOT A SOUTH AFRICAN CITIZEN, PLEASE TICK ONE OF THE OPTIONS BELOW

INTERNATIONAL APPLICANT WITH PERMANENT RESIDENCE

INTERNATIONAL APPLICANT WITH TEMPORARY RESIDENCE

Please note that international applicants will be required to produce either a permanent residence permit or a study permit in order to register.
It is your responsibility to apply for the necessary permit in good time.

SECTION C: SECONDARY EDUCATION

HIGHEST SCHOOL GRADE COMPLETED GRADE 9 GRADE 10 GRADE 11 GRADE 12 NOT EXEMPTED GRADE 12 EXEMPTED

GENDER MALE FEMALE ETHNIC GROUP*

ASIAN BLACK COLOURED INDIAN WHITE

*Please note that this question is asked to allow the institution and the Government to track progress in the transformation of Higher Education.

MARITAL STATUS SINGLE MARRIED WIDOW/ER DIVORCED

LAST EDUCATIONAL INSTITUTION / SCHOOL ATTENDED

YEAR AND MONTH GRADE 9/10/11/12 COMPLETED Y Y Y Y M M

HOME LANGUAGE MOTHER LANGUAGE

ENGLISH AFRIKAANS ISI-XHOSA ISI-ZULU ENGLISH AFRIKAANS ISI-XHOSA ISI-ZULU OTHER

OTHER (SPECIFY): OTHER (SPECIFY):

SECTION D: GENERAL INFORMATION

WHERE DID YOU HEAR ABOUT OUR COLLEGE?

FRIENDS TEACHERS FAMILY TALK AT YOUR SCHOOL

OUR WEBSITE PROMOTIONAL ITEMS RADIO COMMUNITY NEWSPAPERS

OTHER NEWSPAPERS PLEASE SPECIFY WHICH NEWSPAPER(S)

CTCC-FORM-2022 PAGE 3 OF 7
APPLICATION FORM VALID FROM 30 SEPTEMBER 2022
GENERATOR: STUDENT ADMINISTRATION
SECTION E: CONTACT DETAILS

HOME RESIDENTIAL ADDRESS

PRIMARY CONTACT OF STUDENT
(No Postal Address)

TELEPHONE CODE & NUMBER POSTAL CODE

E-MAIL

PERSON RESPONSIBLE FOR PAYMENT OF ACCOUNT

TITLE SURNAME INITIALS

HOME POSTAL ADDRESS / ACCOUNT ADDRESS

TELEPHONE CODE & NUMBER POSTAL CODE

E-MAIL

STUDY ADDRESS OF STUDENT

(Where you stay while studying)
(No Postal Address)

TELEPHONE CODE & NUMBER POSTAL CODE

E-MAIL

CONTACT DETAILS OF PARENT, GUARDIAN OR NEXT OF KIN FAMILY RELATION

NAME MOTHER

SURNAME FATHER

INITIALS TITLE GRANDMOTHER

IDENTITY NUMBER BROTHER
TELEPHONE CODE & NUMBER (H) SISTER
TELEPHONE CODE & NUMBER (W) AUNT

FAX NUMBER UNCLE

CELL PHONE NUMBER (COMPULSORY) GUARDIAN
E-MAIL ADDRESS (COMPULSORY) GRANDPARENT

WEBSITE PARTNER
ADDRESS (PHYSICAL) SPOUSE

POSTAL CODE

WHAT DID YOU DO LAST YEAR?

LEARNER AT THIS TVET PROVIDER HIGH SCHOOL STUDENT

UNIVERSITY STUDENT WORKING IN LABOUR FORCE

UNIVERSITY OF TECHNOLOGY STUDENT UNEMPLOYED

HIGHER EDUCATION COLLEGE STUDENT ENROLLED IN A FOREIGN POST

OTHER TVET COLLEGE STUDENT

OTHER ACTIVITY:

WHICH PROVINCE ARE YOU FROM? GP NW LIM MP NC KZN EC WC FS FOREIGNER

CTCC-FORM-2022 PAGE 4 OF 7
APPLICATION FORM VALID FROM 30 SEPTEMBER 2022
GENERATOR: STUDENT ADMINISTRATION
SECTION F: DISABILITIES / SPECIAL NEEDS YES NO

Indicate any disability that is applicable to you, here. If you have a disability / special need, but choose not to disclose it in this form,Cape
Town City College is under no obligation to assist or accommodate you with regard to that disability / special need.
01 ADHD – ATTENTION DEFICIT DISORDER 02 AUTHISTIC SPECTRUM DISORDER

03 BEHAVIOURAL/CONDUCT DISORDER 04 BLINDNESS

05 CEREBRAL PALSIED 06 DEAFNESS

07 DEAF/BLINDNESS 08 EPILEPSY

09 HARD OF HEARING 10 MILD/MODERATE INTELLECTUAL DISABILITY

11 INTELLECTUAL DISABILITY 12 PARTIALLY SIGHTNESS/LOW VISION

13 PARTIAL DISABILITY 14 SEVERE INTELLECTUAL DISABILITY

15 SPECIFIC LEARNING DISABILITY 16 PSYCHIATRIC DISORDER

17 DYSLEXIA 24 QUADRIPLEGIC

25 AMPUTEE MULTIPLE (SPECIFY)

OTHER (SPECIFY)

SECTION G:
MEMORANDUM OF AGREEMENT

Should my application be successful, I, (Name and Surname of Student) declare that:

1. I will acquaint myself with the rules and policies, including the disciplinary code of conduct of Cape Town City
College and willabide by them;
2. I waive any claim against Cape Town City College, resulting from any act or omission on my part during tuition, sport, tours,
practicalsor in Cape Town City College Residence;
3. I accept responsibility for the care and safekeeping of all Cape Town City College property issued to me for training;
4. I will inform the College immediately, in writing, should I change my address or cancel or change my course (programme) or
any subjects in accordance to the Cape Town City College Financial Policy;
5. I am aware that interest, fees and legal costs will be recovered from me should I fail to timeously fulfil my financial commitments
towards the College (the account will be handed over to a debt collection agency);
6. I accept full responsibility and liability for the payment of the total of all class fees as well as any other fees
determined by Cape Town City College at the date of enrolment; Refunds for any withdrawals after enrolment will
only be considered in exceptional circumstances;
7. I am aware that my enrolment is valid only if it complies with the relevant regulations of the College; not withstanding
provisional acceptance of this enrolment by the College; account will be handed over to debt collection agency;
8. I am capable of concluding an agreement and am legally competent to sign this application and may therefore enter
unassisted into an agreement with the College; and
I sign this application and enter into an agreement with Cape Town City College with the permission of my parents (a) /
guardian (b)
/ husband (c); (Delete (a), (b) or (c), whichever is applicable);
9. I will not claim compensation for photos taken, voices used, student participation in functions, etc. and accept that any photos
used for publicity reasons will be the property of the College;
10. I will adhere to the Cape Town City College Exam policy i.e. 50% or 40% (where applicable) plus 80% class attendance;
11. All particulars given by me in this form are true and correct.
12. I hereby give consent to the Cape Town City College to have my personal information made available for statistical and research
purposes. Where required in terms of national policies the College will share my personal information with national departments
such as, but not limited to, the Department of Higher Education and Training (DHET) and with prospective Work Integrated Learning
(WIL) host employers. My details may also be shared with external partners of the College in order to provide additional services
to students. I am aware that the College is unable to avoid this.

SIGNATURE OF APPLICANT DATE

If the applicant is a minor, the parent/legal guardian/major must complete the following:

I, THE UNDERSIGNED, (FULL NAME AND ID) IN CAPACITY AS

PARENT / LEGAL GUARDIAN / SPOUSE TO (STUDENT FULL NAME AND ID)

am jointly and separately responsible for monies, which the above applicant may at any stage owe to Cape Town City College in
terms of theagreement that he/she concludes with the College.

SIGNATURE OF PARENT OR LEGAL GUARDIAN DATE

CTCC-FORM-2022 PAGE 5 OF 7
APPLICATION FORM VALID FROM 30 SEPTEMBER 2022
GENERATOR: STUDENT ADMINISTRATION
SECTION H : SELF-DECLARATION ON CRIMINAL OFFENCES / RECORD(S)

THE COMPLETION OF THIS SECTION IS COMPULSORY

DETAILS OF APPLICANT / PROSPECTIVE STUDENT

NAME
SURNAME
IDENTITY NUMBER

HAVE YOU EVER BEEN CONVICTED OF A CRIMINAL OFFENCE* IN SOUTH AFRICA OR ANY OTHER COUNTRY? YES NO
HAVE YOU EVER BEEN CHARGED WITH A CRIMINAL OFFENCE* IN SOUTH AFRICA OR ANY OTHER COUNTRY? YES NO
HAVE YOU EVER HAD A COURT INTERDICT GRANTED AGAINST YOU IN SOUTH AFRICA OR ANY OTHER COUNTRY? YES NO
*Please note, this does not apply to offences under the Road Traffic Acts.
IN THE EVENT THAT YOU HAVE ANSWERED YES TO ANY OF THE QUESTIONS ABOVE, PLEASE PROVIDE THE DETAILS BELOW:
DATE COURT OFFENCE COURT OUTCOME

By signing below, I acknowledge that Cape Town City College may make enquiries to check the accuracy of the information provided
and theCollege reserves the right to carry out criminal background checks on all applicants.
Cape Town City College reserves the right not to proceed with my application if I provide any information in this application form which,
inreasonable opinion of the College, renders me unsuitable to study at the College.
If I provide any false or misleading information or do not divulge the information requested, Cape Town City College reserves the right not
toproceed with my application, withdraw any offer to study or immediately terminate my studies with the College.

SIGNED NAME IN PRINT

THIS DAY OF 20

SECTION I : INDEMNITY FORM

NB. IT IS COMPULSORY THAT THIS CONTRACT BE SIGNED BY ALL PARTIES CONCERNED.

CAPE TOWN CITY COLLEGEPRACTICAL TRAINING OPPORTUNITIES: INDEMNITY FORM CLAIMS FOR DAMAGES ENTERED BY
STUDENTS AND/OR THEIR PARENTS AND/OR THEIR GUARDIANS

I, (FULL NAME AND ID OF STUDENT)

the undersigned hereby declare that I shall not institute any claim of any nature whatsoever against Cape Town City College or any
employee of Boland College, who is acting within his or her employment capacity, nor shall I in any way whatsoever hold Cape Town
City College responsible for any loss or damage that 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 Boland College, with regards to the journey to and from the
practical training excursion and with regards to any activities at the excursion, regardless of the way in which such loss or damage
may occur and regardless of who or what may be responsible. I undertake to participate in any activity that I am expected to participate
in, on my own responsibility;voluntarily taking on any risk I expose myself to in connection with such activity.

I hereby confirm that I have acquainted myself with all the information and rules in connection with the practical training opportunities,
and that I am, as a registered student of Cape Town City College, bound to adhere to the general rules and regulations of Cape
Town City College.

I furthermore declare that, in case I am injured and cannot personally give consent to medical treatment or any other essential medical
intervention, the supervisory staff may sign the necessary letters of consent on my behalf.

As far as I know, I do not suffer from any physical disability or illness that would make it inadvisable for me to attend the practical
activities. However, I do wish to bring the following to your attention:

I confirm that all the above information is true and correct.

THUS SIGNED AT ON THIS DAY OF 20

STUDENT PARENT / GUARDIAN / SPOUSE

CTCC-FORM-2022 PAGE 6 OF 7
APPLICATION FORM VALID FROM 30 SEPTEMBER 2022
GENERATOR: STUDENT ADMINISTRATION
 ADMINISTRATION
ACADEMIC
STUDENT
CHECKLIST

Did you fill in the name of the field of study you are applying for?

If you previously studied at another higher education institution, have you attached your academic record?

Did you sign the form?

If you are under 18 years of age, did your parent/guardian sign the form as well?

Did you attach proof of residential address?

If already matriculated, did you attach a copy of your National Senior Certificate/Evaluation?

Did you take note of the Language Policy?

Did you sign the indemnity/Memorandum of Agreement?

Certified copy of your ID/Passport attached?

Once completed, please submit the application form to the campus where you intend studying by hand or by post. Kindly note that
Cape Town City College will not accept responsibility to send applications between campuses on a prospective student’s behalf. It
is the prospective student’s responsibility to ensure that the application is sent to the correct campus. A prospective student must also
ensurethat the course they are applying for is offered at the campus to which they apply. Please consult
www.capetowncitycolleges.com for a list ofprogrammes offered.

To hand deliver:

PRETORIA CAMPUS
Pretorius Street
ARCADIA
405

Tel: 012 884 0090

To post:

PRETORIA CAMPUS
Pretorius Street
ARCADIA
405

Tel: 012 884 0090

CTCC-FORM-2022 PAGE 7 OF 7
APPLICATION FORM VALID FROM 30 SEPTEMBER 2022
GENERATOR: STUDENT ADMINISTRATION