Charlson Academy Special Needs

Application for Admission 2025

NPO Number: 305-046 | Motto: GROWTH IS NEVER BY MERE CHANCE; IT’S THE RESULT OF FORCES WORKING TOGETHER.

1. Learner and Application Details

Child’s Name & Surname

Child’s ID No.

Date of Birth

Sex

Home Language

Grade to Start (2025)

Previous School Information

Last Grade Done

Name of School Last Attended

Reason for Leaving Previous School

Has your child been expelled by any school?

Yes

No

Has your child shown any aggression?

Yes

No

If Yes to either, please give reason(s):

2. Medical and Special Needs Information

Disability (if any)

Student’s need for special care (Specify the problem the student has)

Chronic Illness (if any)

Allergies (Please detail)

Medication & Medical Aid

Medication Given (Name/Dosage)

Morning Medication Time

Afternoon Medication Time

Name of Medical Aid

Medical Aid No.

Name of Principal Member (Medical Aid)

3. Father/Guardian Details

Name(s)

Surname

Occupation

Physical Address

Cell 1 (Primary)

Email Address

4. School Fees & Boarding 2025

Mandatory Enrollment Fees

Total Mandatory Enrollment Fee: R1,600.00 (Non-Refundable)

(R1,000 Registration Fee + R600 Admin Fees. Mandatory at start of year or enrollment.)

Tuition Fee Options

Grade Level	Monthly (12 Payments)	Monthly (11 Payments)	Annual (11 Payments)
Grade 0-R	R1 500.00	R1 640.00	R16 500.00
Grade 1-6	R1 600.00	R1 745.00	R17 600.00
Grade 7-12	R1 700.00	R1 855.00	R18 700.00

Select Preferred Payment Option for Tuition Fees

Boarding Option (Optional)

Monday to Friday (R3,500.00 per month)
Goes home every weekend.

7 Days a Week (R4,500.00 per month)
Goes home once every month end and school holidays. (R1,000 Deposit required.)

No Boarding Required (Day Scholar)

5. Required Documents Checklist

Please ensure copies of the following certified documents accompany this application:

Student’s **Birth Certificate**

Parent/Guardian **I.D.**

Student’s **Medical History**

Student’s **Immunisation Record**

Student’s **Latest Report**

One small **ID Photo**

All **Department of Health** Documentation

6. Declaration and Agreement

By checking the boxes below, I/We declare that I/We have read, understood, and agree to the terms and conditions outlined in the Charlson Academy documents, including the School Fees Policy, Code of Conduct, and the following commitments:

I/We acknowledge that I am **jointly and severally liable for payment** of all school fees, and that **if any fees are not paid on the due date, the whole balance of the outstanding fee will immediately become due and payable.**

I/We agree to abide by all school policies, rules, and the Code of Conduct.

I/We agree not to hold Charlson Academy responsible for any injury, sickness, theft, or loss of property.

I/We commit to pay all costs incurred for damages or losses to school property caused by the learner.

I/We understand that one term’s written notice is required if the student is leaving the school.

Parent/Guardian 1 Name in Full

Date Signed

By clicking ‘Submit Application’, you digitally sign this agreement.

✅ Application Submitted Successfully!

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