7/28/2019 Nsc Gr12 Entry Form Repeater Candidates Nov 2013 Official

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A. ALL CANDIDATES

ALLE KANDIDATE

Qualification:Kwalifikasie

Registration type: R-RepeaterRegistrasie tipe: R-Herhaler

Year of First NSC Examination and

Examination Number:Examination/Eksamen Nr

Jaar van Eerste Eksamen en

Eksamennommer:Center/Sentrum Nr

School where you wish to write: (For office use only)Skool waar u wil skryf: (Slegs vir kantoorgebr

B. PERSONAL INFORMATION

PERSOONLIKE INLIGTING

e.g. 1 9 9 5 0 8 1 6

y y y y m m d d Gender/Geslag:Date of birth: M - Male/Manlik ORGeboorte datum: F - Female/Vroulik

- oregn assporR - RSA ID Buitelandse Paspo

ID type:pe

urname:an:

rs names:oorname:

Race: (For statistical purposes only) A - Asian B - Black C - Colour I - Indian W - White U - UnspecifiedRas: (Vir statistiese doel alleenlik) Asier Swart Kleurlin Indier Blanke Ongespesifiseer

Special needs: A - Aphasic/Dyslecti D - Deaf B - Blind O - OtherSpesiale behoeftes: Afasie/Disleksie Doof Ander

Mathematical disorder: M - Mathematical disorderWiskundige stoormis: Wiskundige stoornis

Home language: A - Afrikaans E - English X - isiXhosa S - SeSotho P - SepediHuis taal: T - XiTsonga V - TshiVenda Z - IsiZulu W - SeTswana I - Siswati

Certificate language: E - English A - Afrikaa X - IsixhosaSertifikaattaal

LOLT E - English A - Afrikaans

C. GENERAL

ALGEMEEN

Postal address:Posadres:

Postal code: Telephone:Poskode: Telefoon:

NB: COMPULSORY FIELD

LW: VERPLIGTENDE VELD

Candidates Cellphone number:Kandidaat se Selfoonnommer:

ENTRY FORM FOR THE NATIONAL SENIOR CERTIFICATE EXAMINATION: NOVEMBER 2013

INSKRYWINGSVORM VIR DIE NASIONALE SENIOR SERTIFIKAAT- EKSAMEN: NOVEMBER 2013

NSC

CLOSING DATE: 15 MARCH 2013

SLUITINGSDATUM: 15 MAART 2013

Year/Jaar

7/28/2019 Nsc Gr12 Entry Form Repeater Candidates Nov 2013 Official

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D. SUBJECT INFORMATION / VAKINLIGTING

i) New SBA (year marks) must be submitted for new subjects(ii) All SBA marks from Nov. 2008 are valid until 2014.i) Nuwe SGA (jaarpunte) moet ingedien word vir nuwe vakke

(ii) Alle SGA punte vanaf Nov. 2008 is geldig tot 2014

Subject code (For office use only)

Vakkode (Slegs vir kantoorgebruik)

I certify that the information above is correct in all respects.Ek sertifiseer dat die informasie hierbo korrek in alle opsigte is.

Candidates Signature: Date:

Kandidaat se handtekening: Datum:

Centre Managers Signature: Date:Sentrumbestuurder se handtekening: Datum:

Deliver or Mail to: Lewer af of Pos aan:

The Director:Examinations Administration Die Direkteur: Eksamensadministrasie

Western Cape Education Department Wes-Kaap Onderwysdepartement

Grand Central Building (5th Floor: Room 5-15) / P O Box X 9114 Grand Central Gebou (5de vloer: kamer 5-15) / Posbus X 9114

Lower Plein Street Laer Pleinstraat

Cape Town Kaapstad

8000 / 8001

NB: ATTACH PROOF OF PREVIOUS NSC (FULL-TIME) EXAMINATION RESULTS

LW: HEG AAN BEWYS VAN VORIGE NSS (VOLTYDSE) EKSAMEN UITSLAE

Instrument - (For Music subjects)

(Vir Musiek vakke)

Description /Subject name

Beskrywing/vaknaam

8000/8001

Submit NEW SBA (YEAR MARK): YES / NO

Dien NUWE SGA (JAARPUNT) in: JA/NEE