Form 8a - Application For Registration As A Visiting Student printable pdf download

APPLICATION FOR REGISTRATION AS A

VISITING STUDENT

(In terms of the Regulations relating to the Registration of Students in

the Supplementary Health Services)

Form 8 A

NON COMPLIANT APPLICATION WILL BE REJECTED AND SENT BACK TO YOU!

Please PRINT and return the FORM to :

BANKING

by registered mail for ease of tracking mail

DETALS

The Registrar, P O Box 205, Pretoria 0001

553 Madiba Street, Arcadia, Pretoria 0083

A. To be completed by the institution abroad where the applicant is a full-time student.

Bank: ABSA

I, the undersigned, hereby certify that:

Branch: Arcadia

Branch Code:

(Mr/Mrs/Miss) : ……… Surname : ………………………………………………....……………………….

632005

Account Type:

First names : ……………………………………….…...............................................……………………

Cheque Account

Passport number : ……………………………………………………………………….……………..…….

Account number

405 00 33 481

is registered as a …………………………………………………………….…student at this institution.

(

)

Annual fees only

He/she is in his/her ……….… year of study for the qualification of ………………..………..…………

Account Number

061 00 00 169

at ……………………………………………………………………………………… (name of institution).

(All other fees)

SEAL/STAMP OF ABROAD

TEACHING INSTITUTION

Include your

HPCSA

registration

number as

reference to

DEAN OF THE FACULTY

DATE

ensure correct

allocation

against YOUR

REGISTRAR OF TEACHING INSTITUTION

name.

B. Please submit together with your application:

a) Registration fee of R523.00. This fee must be remitted by a bank draft drawn on a bank in South Africa.

Registration fees are subject to review.

b) A certified copy of the applicant’s passport.

C. To be completed by the University in South Africa where student is to be temporarily registered.

(NO ALTERATIONS TO THIS DOCUMENT WILL BE ACCEPTED)

I, the undersigned, hereby certify that:

(Mr, Mrs, Miss) : .......... Surname : ……………………………………………………………………………………………….

First names : ………………………………………………………………………………………………………………………..

will commence attendance of a course or courses in the ………………............. (first, second, etc.) year of study in the

Faculty of ………………………………………………………………….…………………………………………………………

This student is enrolled for a course in (subject) …………………………………………..……… in a temporary capacity

for a period not exceeding one academic year and not for degree purposes.

The student concerned will attend in the Department of …………………………………….…………..…………… at this

University from the ………. (day) ……….………….. (month) 20…... to ………. (day) ……….…..……. (month) 20…....

DEAN/REGISTRAR

DATE

I certify that the application meets the requirements as outlined in section B and that I have verified the application:

Registration Officer: ………………………………………………. Signature: ……………………………………………. Date: ………………………………………………

NB: Please note that the Council, in the normal course of its duties, reserves the right to divulge information in your personal file to other

parties.

Updated/LS/06-2014

Form 8a - Application For Registration As A Visiting Student

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