Revised 27 November 2012 1

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APPLICATION FORM

PLEASE ENCLOSE THE FOLLOWING WITH YOUR APPLICATION FORM AND TICK THE APPROPRIATE BOX: A certified copy of your identity document Certified copies of all academic qualifications

A certified copy of your marriage certificate (married women ONLY) A copy of your salary advice not older than two months

APPLICATION FOR ENROLMENT FOR THE FOLLOWING PROGRAMME: Programme Code (for office use only):

Surname: Initial(s)

First Name(s):

Maiden Name (if applicable):

Population Group: Asian Black Coloured White Gender: Male Female

Title (Prof/Dr/Mr/Ms): Date of Birth: Y Y Y Y M M D D

ID/Passport Number: Age

Home Language:

Language Preference: English Afrikaans Study material will be issued in the language indicated where available.

Marital Status: Single Married Widow/Widower Divorced

Contact Details: Home Tel.: ( C O D E ) Work Tel.: ( C O D E ) Fax: ( C O D E ) E-mail Address:

Cell no. you wish to be contacted on:

Postal Address: Postal Code

Physical Address:

Postal Code

Work Address:

Postal Code

Relative Details: Address: Postal Code Relationship:

Home Tel.: ( C O D E ) Work Tel.: ( C O D E )

Disability: Yes No Specify: _______________________________________________________________________ (statistics for ministry)

I have access to the following: (Mark with an X) Computer E-mail Fax Internet Wap-Enabled Cellphone Telephone Television DVD Player Facebook Twitter Mobile/Cellphone

STUDENT NUMBER (Office use only)

Marketer Code:

PERSONAL INFORMATION OF APPLICANT

Courier address for the delivery of books (if applicable to your programme choice). Available daily between 08:00 and 16:00.

Office

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WORK EXPERIENCE (Compulsory)

How did you hear about OLG? (Mark with an X) Colleagues Family or Friends Magazines Newspaper NWU Sales Person Posters Radio School Technical College Technikon Television University Website Facebook Twitter

Grade 10 Date obtained: _________________________ Grade 12 Date obtained: _____________________________

Certificate – Specify: _______________________________________________________________ Date obtained: ______________________________

Diploma – Specify: ________________________________________________________________ Date obtained: ______________________________

Degree – Specify: ____________________________________________________________________Date obtained: ______________________________

Other – Specify: ___________________________________________________________________ Date obtained: ______________________________

Place of employment: Position held: Start date: End date (if applicable):

___________________________________________ _________________________________________ _________________________ ___________________________

___________________________________________ _________________________________________ _________________________ ___________________________

___________________________________________ _________________________________________ _________________________ ___________________________

EASTERN CAPE Bisho Bizana Butterworth Cradock East London Elliot Graaff-Reinet Grahamstown Idutywa Joubertina King William’s Town Lusikisiki Mount Fletcher Mount Frere Mthatha (Umtata) Port Elizabeth Queenstown Sterkspruit FREE STATE Bethlehem Bloemfontein Frankfort Harrismith Ladybrand Welkom GAUTENG Alberton Brixton Roodepoort Kenmare Pretoria Springs Vereeniging KWAZULU-NATAL Durban Empangeni (AGS)

Estcourt Greytown Holy Cross Parish

(Empangeni) Jozini

Kokstad

Ladysmith Matatiele Mkuze Newcastle Ngwelezane Library (Empangeni)

Nongoma

Pietermaritzburg

Pongola Port Shepstone Stanger Ulundi Vryheid MPUMALANGA Elukwatini Ermelo Graskop Groblersdal Kamhlushwa Kinross Lydenburg Middelburg Nelspruit Piet Retief White River NORTH WEST Delareyville Klerksdorp Lichtenburg Mafikeng Potchefstroom Rustenburg Taung Vryburg NORTHERN CAPE Colesberg Hopetown Kimberley Kuruman Upington NORTHERN PROVINCE (LIMPOPO) Giyani Jane Furse Lephalale (Ellisras) Makhado

(Louis Trichardt) Modimole (Nylstroom)

Phalaborwa Polokwane (Pietersburg)

Thabazimbi Thohoyandou Tzaneen WESTERN CAPE George Oudtshoorn Parow Vredenburg Vredendal Worcester

Open Learning Group® absolves itself from any action whatsoever, should an applicant select a programme which is not recognised by the Department of Education in their particular situation.

A. BEdHons (NQF 7) [Please refer to the Language Policy in the Prospectus] (NPDE/PTD/JPD/ACE, etc.) Choose ONE of the following specialisations: 1. Education Management, Law and Systems [O608P] – choose ONE of the following optional modules: 1. Human Rights in Education [ONWR623] OR Particularisation of Educational Systems [VGLO621] 2. General Teaching and Learning [O601P] 3. Learner Support [O610P] 4. Mathematics Education [O607P] – Contact sessions restricted to George, White River, Polokwane, Durban and Potchefstroom. (Proof of permanent Maths teaching required.)

PLEASE CHOOSE AN EXAMINATION CENTRE ( ) AND A CONTACT SESSION CENTRE ( ) FROM THE FOLLOWING LIST:

SCHOLASTIC AND PREVIOUS QUALIFICATIONS (Mark with an X)

CHOOSE YOUR PROGRAMME, SPECIALISATION AND/OR MODULES

Revised 27 November 2012 3

B. Advanced Certificate in Education (ACE) [Please refer to the Language Policy in the Prospectus] Choose ONE of the following specialisations: 1. Professional Educator Development: Foundation Phase [O445P] 2. Professional Educator Development: Intermediate & Senior Phase [O446P] 3. Professional Educator Development: Life Orientation [O447P] 4. Professional Educator Development: Mathematics Literacy [O444P] Option 1 (O444P) – If you have a 480 credit teacher qualification Option 2 (O444P_FULL) – If you have a 360 credit teacher qualification (for groups of 20 in a specific area only)

5. Mathematics GET-Band [O443P] 6. English Education [O433P] 7. History Education [O435P] 8. Technology Education [O426P] 9. Movement Science Education [O440P] 10. Geography Education [O434P]

C. National Professional Diploma in Education (NPDE) [This programme is only offered in English] Choose ONE of the following: NPDE – You may only register for one year at a time. 1st Year – RPL (Recognition of Prior Learning) 1st Semester and exams 2nd Semester (refer to Section A) 2nd Year – RPL (Recognition of Prior Learning) – No Exams (refer to Section B) 3rd Year – Only Exams (both semesters) (refer to Section C) 1st Year – National Professional Diploma in Education (NPDE) [Provide proof of current teaching position and at least five years teaching experience] SSEECCTTIIOONN AA 1. Choose ONE of the specialisations: NPDE Foundation Phase NPDE Intermediate & Senior Phase NPDE Senior & FET Phase 2. For Foundation Phase choose ONE of the MAJOR modules below;

for Intermediate & Senior Phase AND Senior & FET Phase choose TWO of the MAJOR modules below: Afrikaans [AFRN125 & AFDN125] English [EGPN125 & EDSN125] Geography [GFPN125 & GFXN125] History [GSAN125 & GSXN125] Learner Support [LBAR125 & LIEP125] Mathematics [WIPN126 & WSXN125] – (Gr. 12 mathematics a pre-requisite) Setswana [TSMN125 & TVXN125]

PLUS: Choose ONE communication module below: Setswana and Afrikaans speaking students must select mother tongue Setswana (mother tongue) [TSCN125] Setswana (non-mother tongue) [TSNN125] Afrikaans (mother tongue) [AKPN125] Afrikaans (non-mother tongue) [AKPN126] English [ESPN125) Zulu [ZUCN125] N-Sotho [NSCN125] S-Sotho [SSCN125] Xhosa [XSCN125]

2nd Year – National Professional Diploma in Education (NPDE) – RPL [Recognition of Prior Learning – no examinations] [Provide proof of current teaching position and at least five years’ teaching experience]

Choose ONE of the specialisations (same as for 1st year). NPDE Foundation Phase NPDE Intermediate & Senior Phase NPDE Senior & FET Phase Applicants entering NPDE in year 2 must also register for CLFE 115: CLFE 115 3rd Year – National Professional Diploma in Education (NPDE) [Provide proof of current teaching position and at least 5 years’ teaching experience] Choose ONE of the specialisations (same as for 1st and/or 2nd year):

NPDE Foundation Phase (choose ONE of the MAJOR modules below) NPDE Intermediate & Senior Phase (choose TWO of the MAJOR modules below) NPDE Senior & FET Phase (choose TWO of the MAJOR modules below)

► The same majors that were taken in the 1st year must be taken in the 3rd year. Afrikaans and Setswana speakers must select mother tongue communication modules.

1. PLUS: Choose ONE of the MAJOR modules below for Foundation Phase OR TWO of the MAJOR modules below for Intermediate & Senior Phase AND Senior & FET Phase: Afrikaans [AFRN315, 325 & AFDN325) English [EGPN315, 325 & EDSN325]

PLUS: Choose ONE communication module below for the 1st semester (different from the one selected in 1st year – if applicable): Setswana (mother tongue) [TSCN315] Setswana (non-mother tongue) [TSNN315] Afrikaans (mother tongue) [AKPN315] Afrikaans (non-mother tongue) [AKPN316] English [ESPN315] Xhosa [XSCN315] N-Sotho [NSCN315] Zulu [ZUCN315] S-Sotho [SSCN315]

PLUS: Choose ANOTHER communication module for the 2nd semester (not the same as 1st semester 3rd year, but same as 1st year): Setswana (mother tongue) [TSCN325] Setswana (non-mother tongue) [TSNN325] Afrikaans (mother tongue) [AKPN325] Afrikaans (non-mother tongue) [AKPN326] English [ESPN325] Xhosa [XSCN325] N-Sotho [NSCN325] Zulu [ZUCN325] S-Sotho [SSCN325]

2. PLUS: Choose THREE of the following learning areas: Learning area: Social Studies [HSCN319] Learning area: Natural Science [NWCN319] Learning area: Life Orientation [LOCN319] Learning area: Technology [TECK315] D. Post Graduate Certificate in Education (PGCE) [Proof of nine weeks’ teaching in Grades 9 to 11 is compulsory] ***Computer access required Select TWO of the following language endorsements: Afrikaans Taalbevoegdheid [AFTB521] English Language Proficiency [ENTB521] Tswana Language Proficiency [TWTB521] Sotho Language Proficiency [SSTB521] Zulu Language Proficiency [ZOTB521] Foreign Language Proficiency [VRTB521]

Select TWO of the following methodologies: English Methodology [ENGD511 & ENGD521] Learning Area Life Orientation Methodology [LLOD511 & LLOD521] Mathematics Methodology [MATD511 & MATD521] *Movement Sciences Methodology [MOVD511 & LLOD521] Where any of the following methodologies are selected, you must select one of two for the Continuation Methodologies: Geography Methodology [GEOD511] Learning Area Social Science Methodology [LASD521] or Additional Subject Methodology: Creativity for Educators [ADSD521] History Methodology [HISD511] Learning Area Social Science Methodology [LASD521] or Additional Subject Methodology: Creativity for Educators [ADSD521] **Accounting [ACCD511] Additional Subject Methodology: Creativity for Educators [ADSD521] or Learning Area Economic and Management Sciences Methodology [LABD521] **Economics [ECOD511] Additional Subject Methodology: Creativity for Educators [ADSD521] or Learning Area Economic and Management Sciences Methodology [LABD521] **Business Studies Methodology [BSTD511] Additional Subject Methodology: Creativity for Educators [ADSD521] or Learning Area Economic and Management Sciences Methodology [LABD521] **Cannot be taken with LLOD511. **Where two of these methodologies are selected, both ADSD521 & LABD521 must be selected.

E. Uniprep for NPDE

Afrikaans [AFRN315, 325 & AFDN325) English [EGPN315, 325 & EDSN325] Geography [GFPN315, 325 & GFXN325] History [GSAN315, 325 & GSXN325] Learner Support [LDIS315 & LPRO325 & LREM325] Mathematics [WIPN315, 325 & WSXN325] Setswana [TSMN315, 325 & TVXN325]

Revised 27 November 2012 4

1. Full amount with registration R . Cash/EFT Cheque

2. Eduloan finance Select an option: Stop order Debit order

Complete and attach the separate Eduloan application form.

3. Credit card option (5,7% levy payable)

3.1 Total cash amount R .

OR 3.2 Budget account 6 Months 12 Months 18 Months 24 Months

Credit card number

Expiry date of credit card Y Y M M

Last three digits on back of credit card Signature of cardholder: __________________________________________________

TERMS AND CONDITIONS 1. Open Learning Group (Pty) Ltd (“OLG”) with the registration number 1997/020392/07, trading inter alia as OLG, is a company who administrates and facilitates distance education and acts as

a disclosed agent on behalf of third-party academic institutions. 2. Availability is limited for all programmes. Registration is at the sole discretion of OLG. 3. You may only register on a modular basis for specified programmes. 4. It is the responsibility of the Applicant to familiarise him-/herself with the requirements and the rules for each programme enrolled for, as well as to the minimum requirements in order to pass

the specific programme. 5. The Applicant warrants that:

5.1 The information provided in the Application Form is both true and correct. 5.2 All additional documentation provided is true and correct copies of the original. 5.3 He/she acquainted him-/herself of the curriculum, the requirements and qualifications of the programme enrolled for. 5.4 If the programme for which the Student is enrolled requires practical work or internship the Student shall comply with such requirements.

6. The Applicant must supply OLG with original documents or certified copies of all documents required in terms of the application. 7. All applications are pre-registered and will undergo an academic- and finance approval process. Once the respective requirements have been met, registration is completed, at which time the

Applicant (then “Student”) will be subject to OLG’s terms and conditions and the rules and regulations of the tertiary institution. 8. ALL SERVICES RENDERED BY OLG AND THE TERTIARY INSTITUTION SUBSEQUENT TO REGISTRATION WILL BE SUBJECT TO OLG’S TERMS AND CONDITIONS AND THE

TERTIARY INSTITUTION’S RULES AND REGULATIONS. THE OLG TERMS AND CONDITIONS, TOGETHER WITH THE STUDENT CODE OF CONDUCT, ARE AVAILABLE ON WWW.OLG.CO.ZA, IN THE OLG YEARBOOK OR ON REQUEST. ALL REQUESTS FOR THE TERMS AND CONDITIONS OR INFORMATION REGARDING THE STUDENT CODE OF CONDUCT, MAY BE DIRECTED TO OLG’S CALL CENTRE ON TEL: 011 670 4850. IT IS THE APPLICANT’S RESPONSIBILITY TO FAMILIARISE HIM-/HERSELF WITH THESE TERMS AND CONDITIONS AND RULES AND REGULATIONS.

9. OLG MAY ON DISCRETION OF THE REGISTRAR, REGISTER AN APPLICANT WITHOUT EVIDENCE OF PREVIOUS QUALIFICATIONS. HOWEVER, SHOULD THE APPLICANT FAIL TO SUBMIT THE REQUIRED DOCUMENTATION WITHIN THIRTY (30) DAYS OF REGISTRATION, THE REGISTRATION MAY BE CANCELLED WHILE THE APPLICANT REMAINS FINANCIALLY LIABLE FOR ALL COSTS INCURRED PLUS A PENALTY FEE (DETERMINED ON AN ANNUAL BASIS).

10. All amendments or adjustments the Applicant wishes to make to his/her application and/or enrolment must be done in writing within 30 (thirty) calendar days from the signature date of the Application Form.

11. OLG reserves the right to cancel a Student’s registration, refuse the Student to write examination or withhold results if payment is not effected as stipulated. Qualifications will not be issued if the account is not fully paid.

12. The Student hereby directs that the relevant programme material and books be send to him/her by mail and for purposes hereof the Student appoints the Post Office as his/her agent for delivery of the programme material to him/her. The Student herewith indemnifies OLG against all liability should the Post Office fail to deliver all or part of the consignment.

13. OLG does not accept responsibility for assignments dispatched by post or otherwise. It is the responsibility of the Student to ensure that assignments reach OLG timeously. 14. A Certificate signed by the accountant of OLG will be prima facie proof of indebtedness to OLG and the Certificate may be used for purposes of instituting action and Judgement. 15. OLG may cede or assign the rights contained herein at any time to any institution without the prior consent of the Student. 16. The address provided in the Application Form by the Student, is his/her address for purposes of delivering legal notices or communications related to the agreement between him/her and

OLG. The Student undertakes to notify OLG of any change in address in writing by prepaid registered post or fax. 17. It is the responsibility of the Student to avail him-/herself of all exam times and venues and/or programmes enrolled for. 18. Subject Credits may be applied for within the guidelines set by the relevant tertiary institution and subject to payment of the prescribed fees. 19. OLG absolves itself from any claim where a qualification is not recognised by the Department of Education. In a case where a Student had falsely claimed to be in possession of a previous

qualification or any other requisite entry requirement, the Student will automatically be de-registered without repayment of fees. 20. THE STUDENT ACKNOWLEDGES THAT HE/SHE IS FULLY LIABLE FOR ALL FEES AND COSTS IN RESPECT OF THE ENROLMENT OF A PROGRAMME AND

ACCEPTS RESPONSIBILITY FOR PAYING THE FULL PROGRAMME FEE ON/BEFORE THE STIPULATED DATES. 21. AN APPLICANT MAY CANCEL HIS/HER APPLICATION WITHIN 7 (SEVEN) DAYS FROM DATE OF RECEIPT OF THE APPLICATION FORM BY OLG WITHOUT ANY CANCELLATION

CHARGES. AS A RESULT OF LIMITED AVAILABILITY IN ALL PROGRAMMES AND NOT LIMITING THE STUDENT’S LIABILITY AS PER PARAGRAPHS 20 ABOVE AND 23 BELOW, CANCELLATION SUBSEQUENT TO THE INITIAL 7 (SEVEN) DAYS SHALL BE SUBJECT TO A CANCELLATION CHARGE (AS DETERMINED ON AN ANNUAL BASIS).

22. No variation or amendment to or waiver of any rights or cancellation hereof will be valid unless in writing and issued and signed by an authorised representative of OLG (except in the event of an increased programme fee).

23. THE STUDENT HEREBY CONSENTS TO THE JURISDICTION OF THE MAGISTRATE’S COURT AND ACKNOWLEDGES THAT HE/SHE IS LIABLE FOR ALL COSTS, INCLUDING COSTS ON AN ATTORNEY AND OWN CLIENT SCALE SHOULD THE PROGRAMME FEES NOT BE PAID ACCORDING TO THE METHOD OF PAYMENT SELECTED IN THE APPLICATION FORM WITHIN 30 (THIRTY) DAYS OF REGISTRATION. ALL AMOUNTS PAYABLE ARE EXCLUSIVE OF COSTS, INCLUDING BANK COSTS AND NO SET-OFF MAY BE APPLIED.

24. No failure by either Party to enforce any provision of this Agreement shall constitute a waiver of such provision or affect in any way a Party’s right to require performance of any such provision at any time in the future, nor shall the waiver of any right arising from any subsequent breach nullify the effectiveness of the provision itself, or be used as an estoppel against any party in respect of its rights under this Agreement.

STATEMENT AND UNDERTAKING I, ________________________________________________________________ (FULL NAMES & SURNAME) CONFIRM THAT I HAVE READ THE TERMS & CONDITIONS AND FULLY UNDERSTAND IT AND THAT I SHALL FURTHERMORE PERSONALLY BE LIABLE FOR THE PAYMENT OF MY ACCOUNT OR ANY PENALTY COST OR ADMINISTRATION COSTS AS STIPULATED ABOVE. THUS DONE AND SIGNED AT ___________________________________________________ ON THIS __________________ DAY OF ____________________________________ 20______

_____________________________________ _____________________________________ APPLICANT OPEN LEARNING GROUP REPRESENTATIVE

BANK DETAILS: First National Bank / Payee: Open Learning Trading Account No.: 620 111 877 98 Branch Code: 251 445 (Pretoria) Use your ID as the reference number

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METHOD OF PAYMENT (select ONE method only)

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