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Funding
Registration (Returning Students)
Step
1
of
4
25%
Please complete and all sections of this agreement and return it with a proof of payment.
Student Name
*
First
Middle
Last
Calendar year you are registering for:
*
Programme you are registering on:
*
Diploma in Fashion Design
Degree in Fashion Design
Advanced Diploma in Fashion
Part-Time Fashion Design Course
Section Break
Student Disability status profile (Medically certified). For each disability listed, select the difficulty level experienced. You will not be disadvantaged by disclosing any pre-existing disabilities. (CONFIDENTIAL)
Seeing
*
No Difficulty
Some Difficulty
A lot of difficulty
Cannot do at all
Cannot yet be determined
May be part of multiple difficulties
Former difficulty none now
Hearing
*
No Difficulty
Some Difficulty
A lot of difficulty
Cannot do at all
Cannot yet be determined
May be part of multiple difficulties
Former difficulty none now
Communicating
*
No Difficulty
Some Difficulty
A lot of difficulty
Cannot do at all
Cannot yet be determined
May be part of multiple difficulties
Former difficulty none now
Walking
*
No Difficulty
Some Difficulty
A lot of difficulty
Cannot do at all
Cannot yet be determined
May be part of multiple difficulties
Former difficulty none now
Remembering
*
No Difficulty
Some Difficulty
A lot of difficulty
Cannot do at all
Cannot yet be determined
May be part of multiple difficulties
Former difficulty none now
Self-Care
*
No Difficulty
Some Difficulty
A lot of difficulty
Cannot do at all
Cannot yet be determined
May be part of multiple difficulties
Former difficulty none now
Disclosure of pre-existing conditions (CONFIDENTIAL)
*
(Any learning disabilities, personal illnesses or health conditions known of and existed prior to registration.) You will not be disadvantaged by disclosing any pre-existing conditions. Please use space provided below.
I declare that: 1. All the information given by me on this form is complete and true. 2. I indemnify the Elizabeth Galloway Academy of Fashion Design against any claims because of my negligence or wilful acts or omissions. 3. Neither I, nor any other person, will hold the Elizabeth Galloway Academy of Fashion Design, or any person involved with Elizabeth Galloway Academy of Fashion Design activities, liable for any expenses or compensation arising from any accident, injury, illness or death during the course of these activities, because of my negligence or wilful acts. 4. I understand that to qualify for moderation my class attendance must be at least 80% for each module.
Signature of Student
*
Student undertaking. (Foreign student who is enrolling) 1. I undertake to comply with Act No. 130 of 1998: Refugee Act, 1998. 2. I undertake to comply with Act No. 19 of 2004: Immigration Amendment Act, 2004. 3. Each year before registration, I will present myself to the Paarl Home Affairs centre to have my study / asylum permit verified. 4. When the Elizabeth Galloway Academy of Fashion Design has received a report from Home Affairs that my study / asylum permit has been verified and I may reside in the country will I be legible to register. 5. I indemnify the Elizabeth Galloway Academy of Fashion Design against any claims because of my negligence or wilful acts or omissions. 6. I accept full responsibility for
Signature of Student
Section Break
Shuttle service: Please complete address and cell number to subscribe @ R 2 500 per term
Address
Street Address
Address Line 2
Phone
Section Break
Parent/ Guardian/ Bursar
*
(The person responsible for payment of the student’s fees) We undertake to treat your personal information in compliance with Act No. 4 of 2013: Protection of Personal Information Act, 2013.
First
Last
Email
*
Phone
*
Relationship to Student
*
Parent/Guardian/Bursar (The person responsible for payment of the student’s fees) I declare that: 1. All the information given by me on this form is complete and true. 2. I indemnify the Elizabeth Galloway Academy of Fashion Design against any claims because of my negligence or wilful acts or omissions. 3. I accept full responsibility for the payment of all the fees associated with the student’s study at Elizabeth Galloway Academy of Fashion Design. 4. I will be liable for payment regardless of whether I have received an invoice or not. 5. I understand that if payment of fees or costs incurred by the student are not be received by the due date, Elizabeth Galloway Academy of Fashion Design may charge interest on overdue payment at a rate of 15% per annum, compounded monthly, up to and including the final date when the full payment is received. 6. Where the student has already been registered for the academic year: I accept the condition that if I, or the student for whom I am paying, discontinues or changes course at any time I will be liable for a reasonable cancellation fee or reasonable reduction. The cancellation fee will be the full amount of the study fees up to the end of the current academic year (the year for which the student is registered) and I will be responsible and liable for the full payment of such fees, unless the student discontinues due to serious injury sustained or serious condition diagnosed after enrolment, which prevents the student from continuing with their year. The person responsible for payment of student fees is encouraged to disclose any pre-existing conditions before enrolment. This information gives personnel the necessary information firstly to advise a different course structure if considered necessary for student success and secondly to be able to treat the student appropriately, especially in case of an emergency. Elizabeth Galloway Academy of Fashion Design has decided on this cancelation fee with regards to discontinuing students, taking into regard the following factors as stipulated by the Consumer Protection Act: • The nature of the service that was reserved, is private higher education that is highly specialised; • Elizabeth Galloway Academy of Fashion Design will have no reasonable potential, acting diligently, to find an alternative student for the remainder of the academic year due to the specialised service being provided; • The general practise of private higher education institutions is to keep students liable for their full study fees until the end of the relevant academic year. 7. The fees which are payable to confirm the reservation on the programme for stipulated academic year cover the registration and kit costs for the year. In the event of cancellation before the academic year starts, i.e. before registration, we may impose a cancellation fee. The following will have regard to the percentage of these initial payments for the relevant programme retained by Elizabeth Galloway Academy of Fashion as a Cancellation Fee: a. For the Introduction to Fashion i. Before 31st December 50% of initial payment ii. Before 30th January 75% of initial payment iii. From 30th January to date of registration 100% of initial payment b. For the 3 year Diploma and Degree (new first years) i. Before 30th September 50% of initial payment ii. Before 31st October 75% of initial payment iii. From 31st October to date of registration 100% of initial payment c. For the 3 year Diploma and Degree (returning students) i. From 21st December to date of registration 100% of initial payment d. For the Advanced Diploma (Specialisation year) i. From 21st December to date of registration 100% of initial payment
Signature of person responsible for payment of fees
*
Signature of Witness
*
Proof of Payment
*
Max. file size: 64 MB.
