Application for Admission 2027 - Khomas Directorate of Education

FORM 2

MINISTRY OF EDUCATION, ARTS AND CULTURE

Basic Education Act, 2020 (Act 3 of 2020)

Application for Admission of Learner to a State School

(Section 20, Regulation 3 and 22 (4))

Khomas Regional Council · Directorate of Education, Innovation, Youth, Sports, Arts & Culture

PART A - APPLICATION FOR ADMISSION OF LEARNER TO A STATE SCHOOL

For the year: 2027 · Applications are FREE of charge

School applied to

Name of School

Tel. No.

School’s Address

Fax No.

Application for admission: Pre-Primary Primary - Grade Secondary - Grade

Particulars of learner

Surname

First Name(s)

Date of Birth (Y Y Y Y / M M / D D)

Gender Male Female

Nationality

Home Language

Unique Identifier (UID) - birth certificate no. (Pre-Primary / Grade 1) or allocated number (Grade 8)

No Namibian birth certificate Yes - UID 7777777 assigned and flagged

Current / previous schooling

Current Grade (where applicable)

Name of current school

Current school’s Postal Address

Tel. / Fax No.

Brothers and Sisters enrolled at the school applied to

Name	Grade

Additional information on learner

General health condition / allergies

Learning difficulties (if any)

Grades repeated

Pre-primary school attended (Grade 1 only)

Means of transport to / from school

Religion or church

Particulars of parents / guardians

Father / Guardian

Title

Initials

Surname

Tel. (Home)

Tel. (Work)

Cell phone

Residential Address

Postal Address

Occupation

Mother / Guardian

Title

Initials

Surname

Tel. (Home)

Tel. (Work)

Cell phone

Residential Address

Postal Address

Occupation

Correspondence & emergency contact

Send correspondence to: Both parents Father Mother Guardian

Learner lives with: Both parents Father Mother Guardian

Person to contact in an emergency if parents are not available

Name

Tel. (H)

Tel. (W)

Declaration

I declare that the information provided above is true and correct. I understand that misleading or false information will result in the immediate cancellation of this application, that applications are free of charge, and that this application does not guarantee a place at the school.

Signature of Father / Mother / Guardian

Date

Conditions

This application is valid for the current year only; no waiting list is kept for the following year.
You will be notified in writing regarding this application.
Misleading or false information will result in immediate cancellation / disqualification.
Only applications with a certified copy of the learner’s birth certificate / passport and the previous term’s report (where applicable) will be processed.
This application does not guarantee a place at this school; parents should also apply at other schools.
The application number is for administrative purposes only and does not indicate priority. Preference is given in order: Namibian citizenship, proximity to the school (Khomas residents first, clause 3.1), Grade 1 learners turning 6 before 31 December, and siblings at the school.
No admission tests, interviews or selection fees are permitted.

Administrative information - to be completed by the school

Application number

KLAS UID

School code

Date received (Y / M / D)

Proof of learner’s age

Birth certificate Yes No Baptism card Yes No

Latest report / proof of promotion

Yes No

Proof of Namibian citizenship

Yes No

If not Namibian, proof of one of: legal resident / valid work permit, foreign diplomat, or valid study permit

Yes No

Decision (received / admitted / waitlisted / not admitted - with reason)

Signature (Principal / Clerk)

Date

Khomas Regional Council, Directorate of Education · Tel +264 61 292 4444 · pr@khomasrc.gov.na · Private Bag 13236, Windhoek · Admissions enquiries: Mr. Dumi M. Litwayi, +264 81 732 6609