Blank Cput Application Template

SECTION A: INSTRUCTIONS

PLEASE READ THE FOLLOWING CAREFULLY BEFORE COMPLETING THE APPLICATION FORM

1General

1.1This form must be completed by all students applying to the Cape Peninsula University of Technology for the first time.

1.2It is in your own interest to ensure that this form is completed in full and that certified copies of all supporting documents are enclosed. If any questions are left unanswered or certified documents are not enclosed, or the contract is not signed, it will cause a delay as the form will be returned to you for completion. Please write in black ink and use block letters.

1.3A separate questionnaire for RADIOGRAPHY QUALIFICATION (ONLY) must be completed, including the application form.

1.4The undergraduate nursing qualification is only open to candidates from the Western Cape.

1.5The closing date for applications for the following year is 31 August, except for all design and architecture programmes for which it is 31 July.

Late application procedures do not apply to international students.

1.6If you do not have a Portfolio or a questionnaire, please contact the Admissions Office at 021 959 6256/6270 (Bellville Campus) or

021 460 3733/3861 (Cape Town Campus).

2Admission requirements

2.1Consult Faculty brochures for minimum admission and specific qualification requirements.

2.2All candidates with Senior Certificate on Higher and, or Standard Grade are still accepted.

2.3All candidates who comply with the minimum requirements are still subject to selection procedures.

2.4In addition to the minimum requirements, all applicants for the design and architectural technology programmes must submit a prescribed portfolio. Please ensure that you obtain the portfolio requirements booklet with this application form.

2.5CPUT offers the opportunity for qualifying individuals to apply for Recognition of Prior Learning (RPL). Before applying please read what the RPL process entails on the CPUT website under “Admissions”. You may apply for Recognition of Prior Learning:

a)If you are 25 years old or older.

b)You have sufficient work experience of at least 5 years.

c)Your work experience is relevant to the qualification that you are applying for.

NB: Closing date for RPL is 31 August.

i

SECTION B: WHERE TO SEND YOUR APPLICATION

Address your application to the ADMISSIONS OFFICE at the postal address as indicated below.

For easy reference the programmes and the campus where it is offered, is shown on the next page. Please check the campus(es) and address your completed application form to the campus where the programme is offered.

BELLVILLE CAMPUSPO Box 1906, Bellville, 7535, Republic of South Africa

CAPE TOWN, MOWBRAY &

GRANGER BAY CAMPUSES PO Box 652, Cape Town, 8000, Republic of South Africa

WELLINGTON CAMPUS Private Bag X8, Wellington, 7654, Republic of South Africa

PLEASE NOTE:

The University is currently in the process of consolidating programmes on its campuses and service points, and, while everything will be done to accommodate you at the campus of your choice, placement remains at the discretion of the University. Certain programmes are only offered at certain campuses.

ii

•LETTER/ESSAY = Applicants are required to submit a motivational letter/essay explaining why they want to study a specific course. •• QUESTIONNAIRE = Applicants applying for any Radiography programme must also complete the radiography questionnaire.

•••PORTFOLIO = Applicants applying for design programmes must submit a portfolio.

iii

iv

STUDENT NUMBER

For office use only

APPLICATION FOR ADMISSION FOR THE YEAR

20

Please read GUIDE TO THE COMPLETION OF THE APPLICATION FORM, the insert in the middle of this form, carefully before completing this application form.

If YES, please supply your student number

NB: Applications will not be processed without a copy of the applicant’s ID or birth certificate and the number in full entered below.

NB: The following question allows the institution and the Government to track the progress of transformation in Higher Education.

NB Please note that the second choice qualification will only be processed if the first choice application has not been successful.

CONTACT DETAILS

CONTACT DETAILS OF PARENT/LEGAL GUARDIAN/FRIEND/RELATIVE RELATIONSHIP (e.g. father)

Telephone (work)

Telephone (home)

Cell phone

Email address

NON SOUTH AFRICAN CITIZENS

PLEASE SPECIFY YOUR

COUNTRY OF ORIGIN

CITIZENSHIP

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

Please note that international applicants will be required to be in possession of a Study Permit in order to register.

2

HIGH SCHOOL OR EQUIVALENT INFORMATION

GRADE 12 EXAMINATION NUMBER

NAME OF HIGH SCHOOL/COLLEGE

VERY IMPORTANT: if you are currently in Grade 12, please submit a certified copy of the following results: Grade 11 final results and Grade 12 results if available.

PREVIOUS HIGHER EDUCATION

If you have already been a student at a Higher Education Institution (for eg. at a Technikon, University, University of Technology or College), please complete this section. Provide the details of your most recent enrolments.

Please attach certified copies of academic record and certificate of conduct.

If you would like to gain academic credit, or if you are applying for exemption or recognition of subjects, please request an application form from the faculty office at the campus to which you are applying.

Include with your application an original academic record and a certificate of conduct; or a certified copy of your previously obtained certificate / diploma / degree.

DISABILITY STATUS

This information will not disadvantage your application.

PROCESSING OF APPLICATION AND/OR RESIDENCE APPLICATION FORM

•Applications will not be processed without the required copies of documents listed in the GUIDE TO THE COMPLETION OF THE APPLICATION FORM (see the insert in the middle of this Application Form).

•Applications will not be processed unless the Legal Undertaking on page 4 of this Application form has not been completed and signed by all the parties concerned.

•Applications for Accommodation in a University Residence will not be processed unless the Contract on page 5 of this Application form has not been completed and signed by all the parties concerned.

3

LEGAL UNDERTAKING (COMPULSORY)

I,……………………………………………………………………ID/Passport number ……………………………………………………......

declare that all the particulars supplied by me in this form are true, complete and correct. I accept that incorrect or misleading information could lead to the cancellation of this application.

1.I undertake:

1.1to comply with all the rules and regulations, including the disciplinary rules, of the Cape Peninsula University of Technology, including any amendments thereof as published from time to time and to acquaint myself with all the provisions thereof;

1.2to notify the Faculty Office immediately if I abandon my qualification of studies and/or change my address;

1.3to acquaint myself with and adhere to all the rules and general regulations applicable to the qualification for which I wish to enroll as well as the rules regarding the payment of fees;

2.I undertake that I will not hold the Cape Peninsula University of Technology liable nor make any claim against the University for any compensation and/or any expenses incurred or damages suffered as a result of or in respect of any injury to me or illness or my death, irrespective of whether any such damages, injury or death may have been attributable to any degree of negligence on the part of the University or one or more of its employees or other person (s) for whose actions it might, but for this undertaking, have been responsible.

3.I am aware that my enrolment is valid only if it complies with the regulations governing the qualification concerned, notwithstanding the acceptance of this enrolment by the University.

4.I accept that, if I abandon or change my qualification of study at any time, no cancellation or reduction of fees will be considered and that I will remain liable for the payment of all fees in full.

5.I agree that the university may provide me with statements of account and any other communiqués by way of electronic communication through data messages. These data messages may be sent to the cellular number provided by me. I am also prepared to accept such messages at my CPUT student e-mail address or at an alternative e-mail address nominated by myself in writing.

SIGNED AT …………………………………… ON THIS …………… DAY OF ……………………......................................….…20. ……………

……….….…………………………………

SIGNATURE OF APPLICANT

Herein assisted as far as may be necessary while the applicant/student is still under the age of eighteen years

I,………..……………………………………………………………ID/Passport Number .………………………………………………………..

the undersigned, hereby acknowledge myself to be jointly and separately responsible for monies which the above-mentioned applicant may at any stage be owing to the Cape Peninsula University of Technology in terms of the agreement that he/she concluded with the Cape Peninsula University of Technology, as set out above, including any change thereto.

SIGNED AT …………………………………… ON THIS …………… DAY OF ………………......................................……….…20. ……………

……….….…………………………………

SIGNATURE OF PARENT/LEGAL GUARDIAN

N.B It is compulsory that this contract is signed by all parties concerned.

WHERE TO SEND YOUR APPLICATION

Address your application to the ADMISSIONS OFFICE at the postal address as indicated.

For easy reference the programmes and the campus where it is offered, is shown on page 3 of the GUIDE TO THE COMPLETION OF THE APPLICATION FORM (see the insert in the middle of this Application Form). Please check the campus(es) and address your completed application form to the campus where the programme is offered.

4

STUDENT NUMBER

SURNAME

First names

ID/PASSPORT NUMBER

I, the undersigned, .…………………………………………… (the Applicant), hereby apply for admission to Residence for the

abovementioned period, and undertake:

1. To pay the required deposit within 14 days from the date of the notification of the reservation of accommodation for me in the Residence, failing which the reservation may be cancelled.

2. To give the Registrar of the University notice, in writing, at least thirty (30) days before the proposed date of admission, of any intention not to take up the accommodation, and accept that, on failure to take up the accommodation without such notice, the University may summarily cancel such accommodation, in which event I shall forfeit the said deposit as liquidated damages.

3. To allow the University, should the accommodation be taken up, to set off the said deposit against the first residence fees becoming due and to retain the balance as a deposit until after the period of residence and I accept that I shall forfeit the deposit as liquidated damages if I fail to take up the said accommodation.

4. In order to ensure accommodation on returning to the Residence, to pay the deposit within such period as may be stipulated in the notification of the reservation of accommodation for me in the Residence. This deposit will be offset against my residence fees on my recommencing such accommodation and I accept that I shall forfeit this deposit as liquidated damages if I fail to take up the said accommodation.

5. In the event of my discontinuing residence for any reason before the end of a semester, or having my accommodation terminated, to forfeit the deposit as liquidated damages, without prejudice to the right of the University to claim payment of any other amounts I may owe it, whether as a result of my breach of contract or otherwise.

6. In the event of having booked accommodation for both semesters in any year, to give the Registrar written notice by no later than 1 April in that year, of any intention not to return to the Residence for the second semester and I accept that, on failure to give such notice, the University shall have the right to summarily cancel my accommodation, in which event I accept liability of payment, as liquidated damages, of the second semester’s residence fees, without prejudice to the right of the University to claim payment of any other amounts I may owe it, whether as a result of my breach of contract or otherwise.

7. To accept the tariff of residence fees and other charges laid down by the University from time to time.

8. To pay residence fees in full prior to taking up accommodation each semester. No student will be admitted unless the full fees are paid in advance.

9. To accept as final the decision of the Registrar of the University in all cases of dispute in connection with or arising out of this agreement.

10. To accept and comply with the House Rules laid down by the University in respect of the Residence from time to time.

I acknowledge that a reduction of fees will not be granted should residence be taken up after commencement of a semester or in the event of termination of residence before the end of a semester, unless specifically agreed to by the University under special circumstances.

I acknowledge that residence fees and other charges are subject to increase from time to time without prior notice.

I acknowledge that the University shall have the right to summarily terminate my accommodation and eject me from the Residence should I breach any aforesaid undertakings, or should I cease to pursue my aforesaid course of study, without prejudice to the rights of the University in respect of any amounts I may owe it and the right of the University to claim forfeiture of any balance of the deposit still held by it.

SIGNATURE OF PARENT/LEGAL GUARDIAN