UJ Application Form 2014 WEB
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DIPOTIO/IMIBUZOTe dingwe ta dipotio
mabapi le kgopelo yagago di ka lebiwa:
011 559 4555
Eminye imibuzo mayelana nesicelosakho ungayidlulisela lapha:
011 559 4555
www.uj.ac.za
ATERESE YA POSO LE KIOAMAKHELI OKUPOSA NOKUDILIVA
AUCKLAND PARKKHAMPHASE YA KINGSWAY/
AUCKLAND PARKIKHEMPASI YASE- KINGSWAY
Magahlanong a Mebila yaKingsway le Yunibesithi
EKhoneni lemigwaqo uKingsway
No-UniversityAuckland Park, Johannesburg
STUDENT ENROLMENT CENTREPO Box 524
Auckland Park2006
Baithuti ba Bodithabathabaka moka
ba swanete go ikgokaganyale Kantoro ya Kamogelo yaBodithabathaba pele ba
ka dira dikgopelo
Bonke Abaundi Bamazwe Omhlabakumele baqale bathintane neHhovisiLokwamukelwa
Kwabamazwe Omhlabangaphambi kokuba benze izicelo
APK: 011 559 4517APB: 011 559 1027DFC: 011 559 6510
FOROMO YA GO DIRA DIKGOPELO/IFOMU LESICELO 2014
/
U
PELE O KA THOMA GO TLATA FOMO YE HLE BALA O BE O SAENE TUMELELO YE E LATELAGO GORE REKGONE GO KGOBOKETA TSHEDIMOO YA GAGO:/NGAPHAMBI KOKUBA UQALE UKUGCWALISA LELI FOMUKUCELWA UFUNDE FUTHI USAYINE IMVUME ELANDELAYO YOKUQOQA ULWAZI LOMUNTU:
Ke/Re amogela, dumela le go kweia gore UJ e swanete go kgoboketa le go omia tshedimoo ya ka gomabaka a thuto, taolo le ditirelo ta thekgo. Ka gona, Ke/Re dumela gore tshedimoo ya ka/rena e omiwe gomabaka a.
Ngi(si)yamukela, ngi(si)yavuma uthi ngi(si)yaqonda ukuthi i-UJ kuanele iqoqe isebenzise ulwazi ngami/ngathiemisebenzini yezemundo, yezokuphatha neyokweseka. Ngi(si)vumela ukusetshenziswa kolwazi lwami/lwethukulokhu.
Tshaeno ya modirakgopelo mengwaga e 18 Tshaeno ya motswadi ge modirakgopelo a le ka ase gaUkusayina komceli kweminyaka eyi-18 Ukusayina komzali uma ngabe umceli ungaphansi
DITAELO TA GO TLATA FOROMO YA GO DIRA DIKGOPELOIZIQONDISO ZOKUGCWALISA IFOMU LESICELO
1. DINYAKWA TA KAMOGELO/IZIMFUNEKO ZOKWAMUKELWA ADMISSION REQUIREMENTS
Hle lebelela pukwana Career Prospectus yeo e hwetagalago go twa go Senthara ya Boingwadio bjaBaithuti go hweta dintlha ka botlalo ta dinyakwa ta kamogelo ta mabapi le lenaneo la dithuto leo o nyakagogo le tsenela. Career Prospectus ye e ka hwetwa go twa go www.u.ac.za.Sicela ubheke izincwajana ezithi Uhlelo lweZiundo ezitholakala Esikhungweni Sokubhalisa Abaundi ukuzeuthole imininingwane egcwele yezimuneko zokwamukelwa ezisebenza kulezo ziqu/uhlelo ouna ukulibhalisela.Le ncwajana Uhlelo lweZiundo ingatholakala ku-www.u.ac.za
2. MATATIKGWEDI A GO TSWALELELA DIKGOPELO/ IZINSUKU ZAMANQAMU ZOKUFAKA IZICELO
26/07/2013 @ 12:00
FAKHALITHI YA THUTO
IFAKHALITHI YEZEMFUNDO
BEd HONS (SAEKHOLOTI SA THUTO)MEd SAEKHOLOTI SA THUTOBEd HONS (ISAYIKHOLOJI YEZEMFUNDO)MEd ISAYIKHOLOJI YEZEMFUNDO
30/08/2013 @ 12:00
BAITHUTI BA BODITHABATHABA
ABAFUNDI BAMAZWE NGAMAZWE
BA KAKARETO/BAFALADI/BAFALADI BAO BANYAKAGO THIRELETO
JIKELELE/ABABALEKI/AMAKHOSELA27/09/2013 @ 12:00
MADULO/ INDAWO YOKUHLALA
FAKHALITHI YA BOKGABO, MOAKANYO LE THUTA BOAGIIFAKHALITHI YOBUCIKO, IMIDWEBO NOKUMISWA KWEZAKHIWO
KA MOKAZONKE IZINHLELO
FAKHALITHI YA DISAENSE TA EKONOMI LE DITHELETEIFAKHALITHI YESAYENSI YEZOMNOTHO NEZIMALI
DITHUTO TA TIKRII YA MATHOMOIZINHLELO ZABANGAKABI NEZIQU
FAKHALITHI YA THUTOIFAKHALITHI YEZEMFUNDO
DITHUTO TA TIKRII YA MATHOMOIZINHLELO ZABANGAKABI NEZIQU
FAKHALITHI YA BOENTENERE LE BOAGI BJA TIKOLOGOIFAKHALITHI YOBUNJINIYELA NOKUBUNJWA KWEZAKHIWO
KA MOKAZONKE IZINHLELO
FAKHALITHI YA DISAENSE TA MAPHELOIFAKHALITHI YEZESAYENSI YEZEMPILO
KA MOKAZONKE IZINHLELO
FAKHALITHI YA TA BOTHOIFAKHALITHI YEZIFUNDO ZOBUNTU
DITHUTO TA TIKRII YA MATHOMOIZINHLELO ZABANGAKABI NEZIQU
FAKHALITHI YA MOLAOIFAKHALITHI YEZOMTHETHO
DITHUTO TA TIKRII YA MATHOMOZABANGAKABI NEZIQU IZINHLELO
FAKHALITHI YA TAOLO/IFAKHALITHI YEZOKUPHATHA KA MOKA/ZONKE IZINHLELO
FAKHALITHI YA SAENSE/IFAKHALITHI YEZESAYENSI KA MOKA/ZONKE IZINHLELO
25/10/2013 @ 12:00
FAKHALITHI YA DISAENSE TA EKONOMI LE DITHELETEIFAKHALITHI YESAYENSI YEZOMNOTHO NEZIMALI
DITHUTO TA KA MORAGO GA TIKRIIIZINHLELO ZABAZUZE IZIQU
TE BOHLOKWA KUDU Hle bala ditaelo ka edi o be o tlate dikarolo ka
moka. Diomo te di sego ta tlatwa ka botlalo di ka se
lekolwe. Fomo ya kgopelo ke e TEE FELA go modirakgopelo omongwe le o mongwe (Hle dira bonnete bja gore ona le maswanedi go thuto yeo o dirago kgopelo goyona).
Go tsenela National Benchmarking Test (NBT)go a nyakega go badiradikgopelo ka moka baoba tsenago la mathomo. (Lebelela websaete yaNBT mo go www.nbt.ac.za goba ikgokaganye lesenthara ya tshedimoo ya NBT mo go 021 6503523).
Hle emela sebaka sa dibeke te 4 pele o ka lebelelamaemo a kgopelo ya gago. O ka dira seo ka goya go www.uj.ac.za moo o tla go kgona go gatialengwalo la mabapi le maemo a kgopelo ya gago.
OKUBALULEKE KAKHULU Sicela uundisise kahle imiyalelo bese ugcwalisa
zonke izigaba. Iomu elingagcwalisiwe ngokuphelele ngeke
lamukelwe. Iomu ELILODWA lokuaka isicelo kumcelingamunye (Kucelwa uqinisekise ukuthi uyaanelayini ukungena ohlelweni oaka kulona isicelo).
Ukugcwaliswa kokuHlola kokuLinganisa amaZingakukaZwelonke (NBT) kuyadingeka kubo bonkeabaqala ukubhalisa. (Bheka isizindalwazi se- NBTwww.nbt.ac.za noma shayela i-call centre ye-NBTku- 021 6503523).
Kucelwa ulinde amasonto ama-4 ngaphambikokuba uhlole ukuthi lihambe kanjani iomu lakho.Ungenza lokho ngokuya ku-www.uj.ac.za laphouzokwazi nokuphrinta khona incwadi mayelananokuhamba kwesicelo sakho.
OKUBALULEKILE:UNGAKHOKHELI UKUFAKAISICELO UMA NGABE UKE
WAKHOKHA NGAPHAMBILI.
SE BOHLOKWA:O SE KE WA LEFA TEFO YA
KGOPOELO GE E LE GORE O ILEWA LEFA NAKO YE E FETILEGO.
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3. DITEFELO TA DIKGOPELO/IMALI YOKUFAKA ISICELOKa kgopelo kgetha e tee ya te di latelago/Sicela ukhokhe ngeyodwa yalezi zindlela: THEKE YE E YAGOGO/ISHEKE ELIYA: Yunibesithi ya Johannesburg: SETLANKANA SA PANKA SA GO TSENYA THELETE ISILIPHU SASEBHANGE SOKUFAKA IMALIDiteelo ta dikgopelo ga di buetwe morago/Imali yokuaka isicelo ayinakubuyiswaR100-00 ka/ngo2014R950-00 ka/ngo2014 Residence deposit
ELA HLOKO: OTARA YA POSO GA E AMOGELWE/QAPHELA: AMAPHOSTAL ODA AWAVUNYELWENB: KHEE GA E AMOGELWE MO KHAMPHASENG. OKUBALULEKILE: IMALI AYEMUKELWA ESIKHUNGWENI.
4. DITOKUMENTE TA THUTO (Dipoelo ta sekolo di nyakega go baithuti bao ba dirago dikgopelo lekga la mathomo)AMAPHEPHA EMFUNDO (Imiphumela yasesikoleni iyimpoqo kubaundi abaqalayo abangakatholi iziqu)
Ditokumente ka moka di swanete go ba dikhophi teo di hlatsetwego, ka ntle le rekhoto ya dithuto le setifkeiti sa boitshwaroWonke amaphepha kumele kube amakhophi aqinisekisiwe, ngaphandle kwerekhodi lezemundo nesitifketi sokuziphatha okudingekakube awesiqobo.
Ditikrii ta tlaseSA/ Umbhalo
wokuqala
Ditikrii ta kagodimo SA/Abangatholiiziqu baseSA
Bodithaba-thaba/
AbamazweOmhlaba
Dipoelo ta maelelo ta Kreiti 11 (ge ga bjale o le ka go Kreiti ya 12)Imiphumela yokugcina yeBanga 11 (Uma ngabe useseBangeni 12) 3 *
Setifkeiti sa ka Godimo GOBA Setifkeiti sa Bosethaba sa Moomo sa go ba le tiieto yamaleba GOBA Setifkeiti sa ka Godimo sa Bosethaba seo se dumelelago dithuto ta tikrii,
diploma goba setifkeiti GOBA setifkeiti sa Lekgotla la go Ikema la Ditlhahlobo.Isitifketi sikaMatikuletsheni NOMA Isitifketi sezeMisebenzi esinemvume eanele NOMAIsitifketi sikaMatikuletsheni esivumayo ukuthi uundele iziqu, i-diploma NOMA IsitifketiseBhodi lokuHlola elizimele (IEB).
3 3 *
Setifkeiti sa sekolo sa Cambridge sa Maemo a A/O, ICGSE/HICGSE, NSSC MAEMO AGODIMO/ A TLWAELOIsitifketi sesikole iCambridge izinga A/0, ICGSE/HICGSE, IZINGA ELIJWAYELEKILE
* *
Dipoelo ta N3/N4/N5/N6/Imiphumela ka-N3/N4/N5/N6 *
Setifkeiti sa peelano sa tokollo sa MarematlouIsitifketi sikaMatikuletsheni esinamamaki amahle esinemibandela *
Lengwalo la tiieto go twa go Lekgotla la Marematlou (bakgopedi baoba se ogo ba aloga ba go twa dinageng ta ka ntle)Incwadi yesiqinisekiso evela eBhodi Kamatikuletsheni (Abaake izicelo abangakatholi iziquabavela kwamanye amazwe)
3
Tekanyeto yeo e sego khophi ya SAQA (bakgopedi bao ba etego ba kile ba aloga babatwantle)/Ukuhlaziywa kwe-SAQA kokuqala (Abaake izicelo asebeneziqu zakwelinye izwe) 3
Setatamente sa dipoelo ta Marematlou/Isitatimende esiqinisekiwe samamaki sikamatikuletsheni 3 3 3
Tikrii goba setifkeiti sa nakong ye e etilego/Iziqu/isitifketi sangaphambili 3 *
Didiploma ta nakong ye e etilego ta Bosethaba/Isiqu sikazwelonke sangaphambili 3 *
Didiploma te dingwe/Amanye amaDiploma 3 3
Kgopelo ya boemo sebakeng sa ditikrii ta ka godimo (e hwetagala leapheng)Isimo sesicelo kwasebeneziqu (sitholakala kuakhalthi) 3 3
Rekhoto ya thuto le setifkeiti sa maitshwaro ge e le gore o ingwadiite instithueneng yenngwe ya thuto ye e phagamego (yeo e sego khophi)Irekhodi lezemundo nesitifketi sokuziphatha uma ubhalise kwesinyeisikhungo semundo ephakeme (eyoqobo)
3 3
Pukwana ya boitsebio/Ikhophi lencwadi yomagisi (eliqinisekiwe) 3
Paseporoto/ Ikhophi lePasipoti (eliqinisekiwe) 3
Bohlatse bja dipoelo tsa NBT/dipoelo /Isiqinisekiso semiphumelo/nesiphetho se-NBT *
5. GO FETOWA GA ATERESE/UKUSHINTSHA KWEKHELIYunibesithi e swanete go tsebiwa ka pejana ka ga diphetoo te dingwe le te dingwe ta aterese ka morago ga ge dioromo diamogetwe Karolong ya Boingwadio bja BaithutiNyuvesi kumele yaziswe ngokushesha nganoma yiluphi ushintsho lwekheli (lokuposa nelendawo yokuhlala) ngemuva kokuhambisa iomuEsikhungweni Sokubhalisa Abaundi.
6. GO PHUMULWA GA KGOPELO/UKUHOXISWA KWESICELOYunibesithi/maelo a bodulo/ Karolo ya Boingwadio bja Baithuti / di swanete go tsebiwa ka pejana ge e le gore kgopelo ye e phumutwegoba e etoitwe pele ga go ngwadiwa leapheng leo le ikarabelago.
Inyuvesi/izindawo zokuhlala/Isikhungo Sokubhalisa Abaundi kumele baziswe ngokushesha uma lesi sicelosihoxiswa noma sishintshwangaphambi kokubhalisa kuakhalthi eanele.
7. MANGWALO AO A AROGANEGO/ IZINCWADI EZIHLUKENEHlokomela gore dipoelo ta gago ta dikgopelo ta dithuto, dikgopelo ta bodulo gammogo le ta thuo ya dithelete goba kadimo di tlatweletwa ka mangwalo a mararo ao a apanego.Sicela uqaphele ukuthi umphumela wesicelo sakho semundo, sendawo yokuhlala, somundaze noma imali yokwebolekwa siyotholakalangezincwadi ezintathu ezahlukene.
D
E
T
A
C
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S
K
E
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ACADEMIC APPLICATION FORM 2014
FILEPLAN NUMBER 9FD/9.1.3.1
FOR OFFICE USE ONLY
APS
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12. Religious afliation (not compulsory)
13. Population group (COMPULSORY) (Inormation required or government reporting purposes)
14. Non-South Arican citizens, indicate your country o origin:
Angola Namibia Countries in Asia
Botswana Swaziland Countries in Australia & Oceania
Lesotho Zambia Countries in Europe
Malawi Zimbabwe Countries in North America
Mozambique Countries in South America
Other Arican countries (Speciy) Other (Speciy)
15. Current and previous activity
15.1 Please indicate your current and previous activity (Please tick all relevant blocks)
Current Previous Current Previous
University student Technical college student
Teachers college student Military service
Technikon student Labour orce
Nursing college student Grade 12/Grade 11 learner
Other (e.g. economically inactive)
15.2 Are you currently in the teaching proession? Yes No
15.3 Name o higher education institution attended (i applicable)
1. Highest grade passed to date
Grade 11 Grade 12 Year
2. Examination number (I already available)
3. Type o certifcate (Mark with an X)
SOUTH AFRICAN MATRIC TYPE INTERNATIONAL MATRIC TYPE
Joint Matriculation Board Full Exemption HIGCSE / AS-Level
Grade 12 [National Senior Certifcate (NSC) withrelevant endorsement]
IGCSE / O-Level
National Certifcate Vocational (NCV)[N3, N4, N5, N6]
IB (International Baccalaureate)
Independent Examination Board (IEB) A-Level
Senior Certifcate (Beore 2008)
Other Matric ( Speciy): Other Matric ( Speciy):
MATRICULATION ENDORSEMENT MATRICULATION ENDORSEMENT
Speciy endorsement type eg certifcate, diploma, degree I applied or exemption at HESA , speciy endorsement:
SECTION C: SCHOOL-LEAVING DETAILS
Arican Coloured Indian White Other
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4. Name o school attended:
School postal address:
City or town
Postal code
5. Attach either a certifed copy o your fnal school-leaving certifcate or fnal Grade 11 marks report (ofcial school stamp required).No mid-year Grade 12 marks will be accepted.
1. PREVIOUS HIGHER EDUCATION STUDIES
Supply ull details o studies at higher education institution(s) as indicated on previous page, i applicable. For registration purposes, theollowing are regarded as higher education institutions: universities, previous technikons, and teachers training and technical colleges. In theevent o discontinuation o studies, indicate the date o cancellation.
Year rom Year to Higher educationinstitutionField o study
(e.g. BA, BCom, MSc (Zoology)) Student numberResult (e.g.cancelled, ailed,
degree obtained)
1. OTHER HIGHER EDUCATION INSTITUTIONS
Are you planning to study at another higher education institution while registered at UJ?
2. DO YOU HAVE A DISABILITY?
The University must be inormed o certain disabilities in order to determine whether it is able to make special arrangements to accommodatepersons with such disabilities. It is the prospective students responsibility to inorm PsyCaD and to make a declaration to the relevantproessional board/s (where applicable) in this regard. Confdential advice can be obtained rom the ofce: People with Disabilities,[email protected] or 011 559 3745.
2.1 I Yes, INDICATE THE NATURE
SECTION D: HIGHER EDUCATION QUALIFICATIONS
SECTION E: OTHER PARTICULARS
Yes No
Yes No
Sight Intellectual (Difculties in learning)
Hearing Emotional (Behaviour & psychological)
Communication (Talking, listening) Multiple
Physical (Moving, standing, grasping) Disabled, but unspecifed
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SECTION F: ADDRESSES (COMPULSORY)
1. APPLICANTS ADDRESSES
1.1 Applicants postal address
1.2 Applicants study address (i known already)
1.3 Street address
1.4 Contact telephone numbers:
HomeWork (i applicable)
Fax number (i applicable)
SA cellphone
International cellphone
Email
2. ACCOUNT ADDRESS
SURETY
I/we the signatory/signatories (hereinater reerred to as the surety/ies) to this agreement, other than the student, hereby bind mysel/ourselvesas surety/sureties and co-principal debtor/s jointly and severally or and with the student (the principal debtor) in solidumin avour o UJ or thepayment o all debts and due ulflment o all obligations o whatever nature and however arising which the student may now or hereater owe to UJ.
2.1 Title (e.g. Mr/Mrs/Ms/Miss)
2.2 Initial(s)
2.3 Surname
2.4 Postal address o party responsible or account
2.5 Street address
2.6 Telephone number o party responsible or account
2.7 ID/Passport number o party responsible or account
2.8 Cellphone number o party responsible or account
2.9 Email
Dialling codeDialling code
Dialling code
Number
Postal code
Postal code
Postal code
Number
Number
Country
Dialling code Number
Postal code
Postal code
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3. ADDRESS: PARENT/GUARDIAN/NEXT OF KIN
3.1 Title (e.g. Mr/Mrs/Ms/Miss)
3.2 Initial(s)
3.3 Surname
3.4 Postal address
3.5 Street address
3.6 Telephone number
3.7 Cellphone number
4. FINANCIAL ARRANGEMENTS
Should you apply or accommodation, your accommodation deposit and your general application ee may be paid in as one amount.NB: You must fll in your IDENTITY NUMBER IN THE DEPOSIT REFERENCE FIELD on the bank deposit slip or the Electronic FundsTranser (EFT).
BANKING DETAILS:ABSA Bank - Auckland Park BranchBranch code - 632005Bank account number - 3240141018 (I using ID number)Bank account number - 2840189565 (I using student number)
You must retain your original proo o payment and only a copymust accompany your application orm.
NB: Students must always state on the deposit slip: Initials and Surname/ID number/Telephone/Cellphone number
A COPY o the deposit slip must accompany your application orm. This deposit can only be made at a branch o ABSA Bank.
Dialling code Number
Postal code
Postal code
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5. SIGNATURE OF APPLICANT: ACADEMIC APPLICATION
*Note: An applicant under the age o 18 must have this orm signed by either o his/her parents. Where an applicant has no parents (e.g. they aredeceased) or the parents are divorced, a legal guardian is normally ofcially appointed. In such cases the legal guardian must sign this orm. Iyou do not have a parent or a legal guardian, a responsible adult amily member (next-o-kin) or other responsible adult who is prepared to makethe declaration and the undertaking must sign with you. The details o the parent/legal guardian must be listed on this orm.
The applicant gives permission or inormation about academic progress to be divulged to the person/bursar liable or payment o ees.The applicant consents to personal inormation being utilised or government and University statistical purposes.
NB: BOTH POINTS 1 AND 2 MUST BE COMPLETED AND SIGNED
1. 2.
I hereby declare that this inormation is correct I hereby declare that this inormation is correct
Initials and surname o applicant please print Initials and surname o person liable or payment oees please print
Signature o applicant (Duly assisted by his/her Signature o person liable or payment o eesparent/guardian, as may be required by law)
Date Date
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RESIDENTIAL APPLICATION
ONLY COMPLETE IF APPLYING FOR UJ RESIDENCE ACCOMMODATION
CLOSING DATE: AT 12:00 ON 27 SEPTEMBER 2013
ONLY FOR: FIRST TIME ENTERING APPLICANTS
1. INSTRUCTIONS FOR PAYMENT OF RESIDENCE DEPOSIT
Proo o payment o a R950deposit must accompany this application
Ten percent o the ull residence deposit is oreited i a students academic application is not successul.
Year in which you require accommodation
1. First study choice e.g. BCom (Acc)
2. SA identity number
OR
Passport number (i international student)
3. Title (e.g. Mr/Mrs/Ms/Miss)
4. Surname
5. First names
6. Telephone number
Cellphone number
Email address
7. Grade 12 year or year o equivalent qualifcation
8. Are you an SA citizen?
9. Population group (compulsory), mark with an X (According to legal requirements and government reporting purposes this section must be completed)
Arican Coloured Indian White Other
A. PERSONAL PARTICULARS/PERSOONLIKE BESONDERHEDE
II
FILEPLAN NUMBER 14FD/14.1.1
STUDENT NUMBER (PREVIOUSLY ALLOCATED)
Yes No
Dialling code Number
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10. STUDENTS WITH DISABILITIES (Please note: All housing is sel-supportive)
WOULD YOU REQUIRE ACCOMMODATION WITH MODIFICATIONS TO SUPPORT YOUR DISABILITY?/
The University must be inormed o certain disabilities in order to determine whether it is able to make special arrangements to accommodatepersons with such disabilities. It is the prospective students responsibility to inorm PsyCaD and to make a declaration to the relevantproessional boards (where applicable) in this regard. Confdential advice can be obtained rom the ofce: People with Disabilities, [email protected] or 011 559 3745.
I Yes STATE THE NATURE
You can only apply or accommodation on the campus where you will be attending classes (Mark with an X)
Auckland Park Kingsway (APK)
Auckland Park Bunting Road (APB)
Doornontein (DFC)
Soweto (SWC)
I you are amiliar with a residence that you would like to be placed in, you may then speciy the name below:
Choice 1
Choice 2
Please not the UJ will try to accommodate you as best as we can, however, once a residence has reached capacity, your second choice or
an alternative will be considered.
Signature o Applicant (Duly assisted Signature o parent/guardian (i minor)by his/her parent/guardian, as may berequired by law)
Initials and surname o applicant Initials and surname o parent/guardian(Please print) (i minor) (Please print)
Date Date
B. ACCOMMODATION
C. SIGNATURE/S
Yes No
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STUDENT AGREEMENT 2014IV
1. Included in the rules and regulations o UJ under this agreement1.1. I hereby undertake to acquaint mysel, abide by and comply with the
UJ Statute, all the rules, regulations, policies and procedures o UJ asamended rom time to time.
1.2. I agree that UJ, through its normal governance bodies, may amend anyrule, regulation, policy or procedure and that I shall be bound to anysuch amendment as soon as it may take eect.
1.3. I acknowledge that the curriculum o the degree, diploma or certifcateprogramme or which I am applying/registering has been prescribed bySenate-approved regulation.
1.4. I agree that a change to my regulated curriculum may only be eectedwith the approval o the curriculum adviser or executive dean inquestion and any such change must be eected in accordance with theprescribed procedure and within the appointed period.
1.5. I agree to update my personal details on the student portal i theychange during my period o study at UJ.
2. Certifcates and documents o entrance2.1 I agree that the University o Johannesburg has the right to cancel my
registration i I provide incorrect inormation or documentation in anapplication or admission and registration (including but not limitedto the ofcial certifcate in respect o my UJ admission, any previousstudy record, and certifcate o conduct) or i I ail to provide materialinormation or documentation.
3 Tuition ees3.1 I/we, the undersigned, hereby assume absolute responsibility or the
payment o any ees that may all due as a result o my studies and/orresidence at UJ on the appointed due dates as determined by the UJrom time to time.
3.2 The terms o payment o the University (including tuition and residenceees) are as ollows:
First semester modules all ees must be paid by 15 April; Second semester modules all ees must be paid by 15 August; Year modules 60% o ees must be paid by 15 April and the
balance by 15 August.3.3 Every signatory to this agreement hereby consents to and authorises UJ
to enquire about creditworthiness rom credit bureaus and to publishany event o non-payment to credit bureaus.
3.4 I confrm that, in the event o my ailure to pay any amount due by ordemanded o me on the due date, all outstanding ees owing to UJ atthat point shall become due and payable in one sum with immediateeect.
3.5 I agree that the nature and amount o my indebtedness to UJ shall atany time be proven by a written certifcate purporting to be signedby or on behal o the Vice-Chancellor o UJ or his duly authorisedrepresentative whose authority need not be proved, acting reasonably
and in good aith, and this certifcate shall constitute prima acie prooo the contents thereo and o the amount o my indebtedness and theact that such an amount is due and payable in any legal proceedingsagainst me.
3.6 In respect o students not ulflling their fnancial obligations on time andas prescribed, the University retains the right:(a) to exclude students rom University residences;(b) to withhold students examination results or diplomas/degrees;(c) to cancel students registration ater the specifed dates and
to hold them liable or payment o the outstanding amounts asagreed upon and signed in the special arrangement made withUJ;
(d) not to allow students to register i the previous years ees havenot been paid in ull;
(e) not to issue a certifcate o conduct; and() to institute legal action against students, who will be liable or all
UJs legal costs.
4. Residence in one o the student residences or housing units o UJI I take up residence in one o the UJ student residences or housingunits or senior students, I hereby undertake to:
4.1 duly complete and sign the application orms with regard to my year oentry and type o residence;
4.2 make mysel amiliar with all the rules, regulations, policies andprocedures pertaining to residence or accommodation occupancy andto comply with these regulations and abide by these rules, policies andprocedures;
4.3 take cognisance o the rules governing the ollowing: temporary and/orpart-time employment, the period o tenancy, the payment and oreitureo boarding ees, the closing dates or payments, the closing dates orthe cancellation o residence, damage to and restitutional damages inrespect o student residences and lodgings, disturbance o the peace,the cancellation o my contract in respect o residence and eviction bythe University.
5. Amendment to this agreement5.1. I acknowledge that, unless expressly changed in writing, all the terms
o this agreement shall remain in orce and shall stand or as long as Iam a registered student o UJ, irrespective o whether or not my studies
may be suspended.5.2. I declare that no amendment or change to this agreement, including thisclause, shall be valid unless it has been duly authorised in writing byeither the Vice-Chancellor or his/her duly authorised representative.
6. Access to inormation6.1. I accept, agree and understand that UJ keeps and processes data and
documents in electronic and paper ormat, including the data suppliedby me during application and registration. UJ may use and transersuch data and use such documents in electronic or other ormats or UJpurposes. This includes but is not limited to the ollowing:6.1.1. UJ may make use o my personal inormation (including my
surname and frst name, identity number, passport number, studentnumber, ace image and fngerprints, as well as my cellphonenumber) or academic, administrative and support purposes.
6.1.2. Details relating to my academic perormance, including my
National Benchmark Test results, may be used in the interesto my own academic development and support which includescommunication with my parent/s, guardian and/or bursarysponsor.
6.1.3. My name, address and phone number may be made available tothe UJ Alumni Ofce and to potential employers or a possibleemployment opportunity or to such other persons as may beindicated i UJ is compelled by law to adhere to the request (e.g.national learner record database as required by the Departmento Higher Education).
6.1.4. Every signatory hereby authorises UJ to collect all o the personaldata supplied by them to UJ respectively or research, statistical,credit control and publication purposes, to retain such data and toprocess the data or the aorestated purposes o UJ and to publishsuch data and make this data available to third parties. Withoutdetracting rom the generality o the aoregoing, the applicant /student irrevocably authorises UJ to account, communicate andreport to the spouse, parents or legal guardians o the applicant/student and any person or body responsible or the payment othe tuition and other ees or who has awarded a bursary to theapplicant /student to pay in part or in ull or the studies and otherexpenses o the applicant /student regarding the academic andgeneral progress o the applicant /student and in respect o anymonies due to UJ and to communicate to all o the aoresaid andany prospective employer all personal data required by such athird party. In general, each signatory agrees to the publicationo personal inormation in any ormat to such third parties as UJmay deem necessary or may be required to do in the conduct oits responsibilities. All signatories to this agreement agree andacknowledge that my/our consent extended to UJ to disseminatepersonal inormation is irrevocable.
7. Cession o intellectual property rightsI hereby cede to the UJ any existing, uture or contingent copyright orany other intellectual property right that may arise rom any incompleteor completed work, including, without limitation, any paper, article,assignment, dissertation, thesis or minor-dissertation, that may in anyway whatsoever have originated or originate rom any study or researchproject I may have undertaken or have launched or may undertake or
I, (ull names and surname in block letters),
identity number /passport number the undersigned, hereby apply/register
as a student o the University o Johannesburg (UJ), subject to the ollowing terms and conditions:
9FD/9.1.2.1
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launch at UJ, irrespective o whether such work has been or may beaccepted or examination, in accordance with national legislation, theUniversitys policy related to intellectual property and the AcademicRegulations. Intellectual property rights will also be applicable to anyexisting, uture or contingent copyright or intellectual property rightsthat may arise rom computer sotware or patent rights, patentableinvention or registrable model programme that has originated or mayoriginate rom any study or research project whatsoever that I haveundertaken or have launched or that I may undertake or launch at UJ.
8. General termsI hereby:
8.1 declare that this agreement which has been completed and duly signedis applicable to my total period o study at UJ;8.2 declare that I have acquainted mysel with, and in the uture will keep
mysel acquainted with, the contents o the Universitys Statute, policies,academic and fnancial rules and regulations pertaining to study at UJand published on the UJ web: http://www.uj.ac.za;
8.3 declare that, in the event o my being under-aged, this agreement isconcluded with the privity consent and assistance o my parents and/orguardian;
8.4 declare that should it be deemed necessary by UJ (as a result o thisagreement) to institute legal proceedings against me, and should I beunsuccessul in such legal proceedings, I shall be liable or the legalcosts according to the attorney and own client scale o ees;
8.5 accept the jurisdiction o the magistrates court in the event o anyaction or claim or damages being instituted or brought against me,irrespective o the extent o the action or the measure o damages;
8.6 consent to an emolument attachment order i UJ should succeed in anylegal action to claim or recover any monies rom me;
8.7 declare that UJ reserves the right to move students to extended degreesi their academic perormance is not adequate in the frst semester;
8.8 declare that in accordance with the rules, regulations, policies andprocedures o UJ, I will give written notifcation to the aculty ofcerconcerned in the event that I should decide:(a) to change my course o study or curriculum;(b) to terminate my studies in part or in their entirety;(c) not to pursue a particular programme o study in the second
semester; orFailure to do so will result in my being indebted in any amounto tuition ees that, owing to my omission, would have becomepayable to UJ.
9. Domicilium citandi et executandi(physical address or ofcial notices)
9.1 I/we, the undersigned, hereby appoint as our domicilium citandi etexecutandi or all purposes in terms o this agreement, including theservice o legal process, the address set out below.
9.2 I hereby elect, or the purpose o serving all process documents andany other notices pertaining to my studies or research at UJ, theaddress entitled Domicilium citandi et executandi(physical address),as stated on this agreement orm.
10. Surety / Parent / Guardian / Spouse10.1 Each signatory (hereinater reerred to as the surety/ies) to this
agreement, other than the applicant /student, hereby bind/s mysel/ourselves as surety/sureties and co-principal debtor/s jointly andseverally or and with the applicant /student (the principal debtor) insolidum in avour o UJ or the payment o all debts and due ulflmento all obligations o whatever nature and however arising which theapplicant /student may now or hereater owe to UJ.(an application ee,
or instance)10.2 Each Surety / Parent / Guardian / Spouse that signs this agreement
consents to the collection and processing o their personal inormationor the administrative purposes o the applicant to this agreement.
D D M M C C Y Y
D D M M C C Y Y
Country: Postal/zip code:
Date:Signature o applicant/student* (Duly assisted by his/her parent/guardian, as may be required by law)
And also signed in his/her own capacity and assisting the applicant /student where necessary by [ull name o parent/legal guardian/next-o-kin/spouse]:
* DETAILS OF PARENT/GUARDIAN/SPOUSE:
Surname:
First name:
Identity number:
Domicilium citandi
et executandi
(physical address) reer to clause 9
Country tel. code:
Telephone number:
Email address:
Date:
* Signature o parent/legal guardian/spouse:
* Note: An applicant/student under the age o 18 must have this orm signed by either o his/her parents. I an applicant /student has no parents (e.g. theyare deceased) or the parents are divorced, a legal guardian is normally ofcially appointed. In such cases, the legal guardian must sign this orm. Iyou do not have a parent or a legal guardian, a responsible adult amily member (next-o-kin) or other responsible adult who is prepared to make thedeclaration and the undertaking must sign with you. The details o the parent/legal guardian must be listed on this orm.
Dialling code:
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INDEMNITY AND UNDERTAKINGExemption and indemnityApplicants/students under the age o 18 years old must be assisted by their parent or guardian. (This must be the same person listed as next-o-kin.)
I, the applicant/student and (where applicable) I, the parent/guardian/next-o-kin/spouse o the applicant/student, declare and agree as ollows:1. I understand and acknowledge that with a view to keeping ees aordable, there is no obligation on the University o Johannesburg (the University) to
take out insurance to cover risks to which applicants/students are exposed while studying at the University.2. Each signatory o this exemption and indemnity waives all rights that he/she may have or may acquire to claim compensation or loss or damage arising
rom the conduct o the University or someone or whose conduct the University is responsible.3. Each signatory o this exemption and indemnity urthermore assumes the obligation o the University or person or whose conduct the University is
responsible in respect o such a liability.4. I understand that or purposes o the exemption and indemnity, the expression conduct includes omissions.5. The exemption and indemnity will not apply where the liability o the University or person or whose conduct the University is responsible is covered by
insurance or a statutory compensation scheme (or example the third party compensation scheme relating to motor vehicle accidents). It will also not applyi the loss or damage arises rom the gross negligence o the University or a person acting on behal o the University.
D D M M C C Y Y
D D M M C C Y Y
Date:Signature o applicant/Student(Duly assisted by his/her parent/guardian, as may be required by law)
And i the applicant/student is under 18 years o age, assisted by [ull name o parent or legal guardian or next-o-kin]:
First name Last name/surname
Date:* Signature o parent/legal guardian/spouse:
* Note: An applicant/student under the age o 18 must have this orm signed by either o his/her parents. I an applicant /student has no parents (e.g. theyare deceased) or the parents are divorced, a legal guardian is normally ofcially appointed. In such cases, the legal guardian must sign this orm. Iyou do not have a parent or a legal guardian, a responsible adult amily member (next-o-kin) or other responsible adult who is prepared to make thedeclaration and the undertaking must sign with you. The details o the parent/legal guardian must be listed on this orm.
ALL APPLICANTS/STUDENTS MUST SIGN BELOW - THANK YOU
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