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  • 1 Rabboni Christian School Hostel Application Form 2018

    OFFICE USE ONLY

    D.O.A: SCHOOL APPLICATION

    COMPLETED:

    GRADE: FORM NO.: DEPOSIT PAID: FAMILY CODE:

    HOSTEL APPLICATION FORM 2018

    PLEASE NOTE: THANK YOU FOR CONSIDERING RABBONI CHRISTIAN SCHOOL HOSTEL FOR YOUR CHILDS CARETAKING. RABBONI IS A PRIVATE

    CHRISTIAN SCHOOL AND HOSTEL. RABBONI DOES NOT OFFER CARE FOR SPECIAL NEEDS LEARNERS OR INTELLECTUAL

    DISABILITIES. ALL HOSTEL POLICIES ARE ALIGNED WITH SCHOOL POLICIES, WHERE APPLICABLE THE HOSTEL HAS ADDED

    POLICIES TO BE USED WITH SCHOOL POLICIES.

    SECTION A: LEARNER INFORMATION

    FIRST NAME: SURNAME:

    DATE OF BIRTH: ID NUMBER:

    AGE: GENDER: MALE FEMALE

    RACE: IMMIGRANT: YES NO

    CITIZENSHIP: NUMBER OF YEARS IN SOUTH

    AFRICA:

    HOME LANGUAGE: SECOND LANGUAGE:

    PHYSICAL ADDRESS:

    POSTAL ADDRESS:

    LEARNERS HOME TELEPHONE

    NUMBER: LEARNERS CELL PHONE NUMBER:

    EMERGENCY CONTACT OTHER THAN

    PARENTS OR GUARDIANS:

    NAME AND SURNAME:

    CONTACT NUMBER:

  • 2 Rabboni Christian School Hostel Application Form 2018

    CURRENT SCHOOL:

    SCHOOL TELEPHONE NUMBER: SCHOOL FAX NUMBER:

    CHILDS CURRENT GRADE:

    HAVE YOUR CHILD EVER BEEN IN A HOSTEL/BOARDINGHOUSE ENVIRONMENT

    BEFORE? YES NO

    IF YES, FROM WHAT AGE?

    WHY WAS YOUR CHILD IN A

    HOSTEL/BOARDING HOUSE?

    LIVED FAR FROM SCHOOL NO SUPERVISION AFTER SCHOOL OTHER REASON

    YES NO YES NO YES NO

    IF YES FOR OTHER REASON, PLEASE ELABORATE:

    WHY DO YOU WANT TO MAKE USE

    OF THE RABBONI HOSTEL FACILITIES?

    WE LIVE FAR FROM SCHOOL SUPERVISION FOR OUR CHILDREN

    AFTER SCHOOL OTHER REASON

    YES NO YES NO YES NO

    IF YES FOR OTHER REASON, PLEASE ELABORATE:

    TELL US MORE ABOUT YOUR CHILD, HIS CHARACTER, MOTIVATIONS AND ASPIRATIONS:

    MY CHILD EAT WHAT IS SERVED TO

    HIM AT HOME YES NO MY CHILD ACCEPTS MY DISCIPLINE YES NO

    MY CHILD HAS CHORES AT HOME YES NO MY CHILD IS A CHRISTIAN YES NO

    MY CHILD CLEANS UP AFTER

    HIMSELF/HERSELF YES NO MY CHILD IS PRONE TO LYING YES NO

    MY CHILD TALKS BACK WHEN I GIVE

    INSTRUCTIONS TO HIM/HER YES NO

    MY CHILD HAS GREAT RESPECT FOR

    GROWN-UPS YES NO

    MY CHILD MAKES HIS/HER OWN BED YES NO MY CHILD WORKS HARD IN SCHOOL YES NO

    MY CHILD CAN DO WHAT HE/SHE

    WANTS AT HOME YES NO MY CHILD IS OFTEN DEPRESSED YES NO

    MY CHILD EATS VEGETABLES YES NO

    MY CHILD ARE ALLOWED TO HAVE A

    BOYFRIEND/GIRLFRIEND WHILE IN

    SCHOOL

    YES NO

    MY CHILD NEVER EATS BREAD YES NO MY CHILD CAN VIEW ANY KIND OF

    MOVIE YES NO

    MY CHILD EXERCISE YES NO MY CHILD LOVES TO READ YES NO

    MY CHILD CAN SWIM YES NO MY CHILD LOVES TO SING YES NO

    MY CHILD GOES TO BED AT ANYTIME YES NO MY CHILD TAKES CARE OF HIS

    BELONGINGS YES NO

    MY CHILD IS OFTEN AGGRESSIVE YES NO MY CHILD IS HELPFUL YES NO

    MY CHILD HAS A BIBLE YES NO MY CHILD ARE ALLOWED TO USE

    SWEAR WORDS YES NO

    TELL US MORE ABOUT YOUR DESIRES AND DREAMS FOR YOUR CHILD:

  • 3 Rabboni Christian School Hostel Application Form 2018

    SECTION B: LEARNERS MEDICAL INFORMATION

    FAMILY DOCTER: DOCTER TELEPHONE NUMBER:

    ADDRESS OF DOCTER:

    I GIVE THE SCHOOL PERMISSION TO ADMINISTER FIRST AID TO MY CHILD WHEN NECESSARY: YES NO

    IN THE EVENT OF A LIFE-THREATENING OR VERY SERIOUS CASE, DO YOU GRANT THE SCHOOL PERMISSION TO TAKE

    YOUR CHILD TO BRITS MEDI CLINIC OR BRITS DISTRICT HOSPITAL?: YES NO

    HAS YOUR CHILD RECEIVED ALL THE NECESSARY IMMUNIZATIONS, INCLUDING HEPATITIS B?: YES NO

    IF NO, PLEASE SPECIFY WHICH IMMUNIZATIONS HE/SHE HAS NOT RECEIVED:

    INDICATE YOUR CHILDS ALLERGIES:

    DOES YOUR CHILD SUFFER FROM ANY CHRONIC CONDITIONS?:

    DOES YOUR CHILD TAKE PRESCRIBED CHRONIC MEDICATION? YES NO

    PLEASE INDICATE THE MEDICATION FOR CHRONIC CONDITIONS?: (PLEASE TAKE NOTE THAT NO MEDICATION IS GIVEN

    BY THE HOSTEL STAFF OR TO ANY LEARNER, MEDICATION TAKEN BY A LEARNER AS PRESCRIBED BY A DOCTER IS THE

    RESPONSIBILITY OF THE PARENT AND THE LEARNER)

    DO YOU HAVE A MEDICAL AID?: YES NO

    MEDICAL AID NAME:

    MEDICAL AID NUMBER:

    MAIN MEMBER OF MEDICAL AID:

    MEDICAL AID OPTION/PLAN:

    MEDICAL AID TELEPHONE NUMBER:

    ANY OTHER ADDITIONAL MEDICAL INFORMATION:

    .

    PLEASE NOTE:

    PLEASE TAKE NOTE THAT WHEN YOUR CHILD IS ILL; WE WILL NOT BE ABLE TO FACILITATE DAILY CARE AND

    SUPERVISION. YOU WILL BE CONTACTED AND YOU WILL HAVE TO COME AND COLLECT YOUR CHILD

    IMMEDIATELY.

  • 4 Rabboni Christian School Hostel Application Form 2018

    SECTION C: SPIRITUAL STANDING

    RABBONI CHRISTIAN SCHOOL IS A BIBLE-BASED CHRISTIAN SCHOOL AND HOSTEL WHERE OUR VALUES ARE

    DEFINED BY THE BIBLE AND THE CHILDREN ARE TRAINED ACCORDING TO GODS WORD. PLEASE ANSWER THE

    FOLLOWING QUESTIONS HONESTLY.

    HAS YOUR CHILD MADE A DECISION TO FOLLOW JESUS CHRIST?: YES NO

    DOES YOUR CHILD ATTEND A YOUTH - GROUP OR MINISTRY? YES NO

    HAS YOUR CHILD BEEN ON A MISSION OUTREACH? YES NO

    DO YOU CONSENT FOR YOUR CHILD TO GO ON LOCAL MISSION OUTREACHES? YES NO

    HAS YOUR CHILD FASTED AND PRAYED BEFORE? YES NO

    HAS YOUR CHILD ATTENDED YOUTH CAMPS BEFORE? YES NO

    HAS YOUR CHILD BEEN BAPTISED? YES NO

    DO YOU CONSENT FOR YOUR CHILD TO BE BAPTISED IF THE CHILD CHOOSES TO BE BAPTISED? YES NO

    HAS YOUR CHILD EVER RECEIVED ANY FORM OF PASTORAL COUNSELLING? YES NO

    HAS YOUR CHILD EVER EXPERIENCED ANY FORM OF DELIVERANCE, AND HAS A TESTIMONY OF THAT DELIVERANCE? YES NO

    AT THE RABBONI HOSTEL BE HAVE DAILY BIBLE STUDIES, DO YOU CONSENT THAT YOUR CHILD MUST ATTEND THESE STUDY

    SESSIONS? YES NO

    FROM TIME TO TIME WE ATTEND YOUTH SERVICES AT CHURCHES AROUND BRITS, DO YOU CONSENT THAT YOUR CHILD

    MAY ATTEND THESE SERVICES? YES NO

    AT RABBONI CHRISTIAN HOSTEL WE USE THE BIBLE AS OUR INSTRUCTION GUIDE, DO YOU CONSENT THAT WE INSTRUCT

    YOUR CHILD TO THE BIBLICAL STATUTES AND GUIDELINES. YES NO

    IS YOUR CHILD A BORN AGAIN CHRISTIAN? YES NO

    DO YOU KNOW WHAT IT MEANS TO BE A BORN AGAIN CHILD OF GOD? YES NO

    PLEASE ADD ANY OTHER RELEVANT SPIRITUAL INFORMATION :

  • 5 Rabboni Christian School Hostel Application Form 2018

    SECTION D: PARENT / GUARDIAN INFORMATION

    NOTE:

    SUPPLY DEATH CERTIFICATE OR PROOF OF DIVORCE WHERE NECESSARY.

    MARITAL STATUS (PLEASE TICK APPLICABLE BLOCK):

    MARRIED: SINGLE: WIDOW/ER: DEVORCED:

    SEPARATED: LIVING

    TOGETHER:

    NEVER

    MARRIED: OTHER:

    WHO IS THE CHILD LIVING WITH?

    IF YOU ARE DIVORCED OR SEPARATED, DO BOTH PARTIES GIVE CONSENT FOR THE CHILD TO BE ENROLLED AT RABBONI

    CHRISTIAN HOSTEL?: YES NO

    WHO IS LEGALLY LIABLE FOR THE PAYMENT OF THE HOSTEL FEES ACCOUNT?:

    FATHER /GUARDIAN:

    NAME: SURNAME:

    IDENTIFICATION

    NUMBER: DATE OF BIRTH:

    HOME ADDRESS:

    EMPLOYMENT

    STATUS:

    UNEMPLOYED: BETWEEN

    EMPLOYMENT: EMPLOYED:

    SELF EMPLOYED: RETIRED: OTHER:

    EMPLOYER:

    (IF SELF EMPLOYED STATE YOUR

    BUSINESS )

    EMPLOYER

    ADDRESS:

    PHONE NUMBER

    WORK: E-MAIL ADDRESS:

    PHONE NUMBER

    HOME: CELL PHONE NUMBER:

    WHAT IS YOUR

    MONTHLY INCOME

    BAND:

    R1 R5000 R5000 R10000 R10000 R15000 R15000 R20000 R20000 R25000 ABOVE R25000

  • 6 Rabboni Christian School Hostel Application Form 2018

    MOTHER /GUARDIAN:

    NAME: SURNAME:

    IDENTIFICATION

    NUMBER: DATE OF BIRTH:

    HOME ADDRESS:

    EMPLOYMENT

    STATUS:

    UNEMPLOYED: BETWEEN

    EMPLOYMENT: EMPLOYED:

    SELF EMPLOYED: RETIRED: OTHER:

    EMPLOYER:

    (IF SELF EMPLOYED STATE YOUR

    BUSINESS )

    EMPLOYER

    ADDRESS:

    PHONE NUMBER

    WORK: E-MAIL ADDRESS:

    PHONE NUMBER

    HOME: CELL PHONE NUMBER:

    WHAT IS YOUR

    MONTHLY INCOME

    BAND:

    R1 R5000 R5000 R10000 R10000 R15000 R15000 R20000 R20000 R25000 ABOVE R25000

    PLEASE SUPPLY US WITH DETAILS OF 2 PERSONS, NOT LIVING WITH YOU.

    ADDITIONAL CONTACT 1:

    NAME: SURNAME:

    RELATION: OCCUPATION:

    HOME ADDRESS:

    PHONE NUMBER

    WORK: E-MAIL ADDRESS:

    PHONE NUMBER

    HOME: CELLPHONE NUMBER:

  • 7 Rabboni Christian School Hostel Application Form 2018

    ADDITIONAL CONTACT 2:

    NAME: SURNAME:

    RELATION: OCCUPATION:

    HOME ADDRESS:

    PHONE NUMBER

    WORK: E-MAIL ADDRESS:

    PHONE NUMBER

    HOME: CELLPHONE NUMBER:

  • 8 Rabboni Christian School Hostel Application Form 2018

    AS A PARENT OF RABBONI CHRISTIAN SCHOOL/HOSTEL I UNDERTAKE TO:

    1. REMEMBER THAT RABBONI CHRISTIAN SCHOOL/HOSTEL IS IN ESSENCE A CHRISTIAN SCHOOL/HOSTEL AND GOVERNED BY BIBLICAL PRINCIPLES AND STANDARDS.

    2. PRAY FOR THE HOSTEL PARENTS AND STAFF AS THEY ENDEAVOUR TO USE THEIR TRAINING AND ABILITIES AND TALENTS TO EDUCATE, DEVELOP AND CARE FOR MY CHILD TOWARDS ADULTHOOD AND MATURITY.

    3. I WILL STRIVE TO BUILD HEALTHY RELATIONS WITH MY CHILDS EDUCATORS AND CARE TAKERS.

    4. SUPPORT MY CHILD IN ALL OUTREACH, ACADEMIC, CULTURAL AND SPORTING ACTIVITIES, AND AGREE THAT HE/SHE SHALL TAKE PART IN ALL OF THESE ACTIVITIES. I WILL ATTEND MY CHILDS EXTRA-MURAL ACTIVITIES AS OFTEN AS POSSIBLE.

    5. SUPPORT THE DISCIPLINARY SYSTEM AS SET DOWN, IN ORDER TO TRAIN MY CHILD ACCORDING TO THE WORD OF GOD TO THE BEST OF THE SCHOOLS/HOSTELS ABILITY. NB - R

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