SAM Registration Form

Student Registration Form
Fill out the form carefully for registration
Student Name
First NameMiddle NameLast Name
Date of Birth
MonthDayYear
Grade
Gender
Primary School/Pre-school
Address
The student will be attending
The student will be attending classes in
Enrolling another student?
Guardian's details
Guardian Name
First NameLast Name
Relationship to student
Email
example@example.com
Mobile Number
Format: (000) 000-0000.
Alternative number
Format: (000) 000-0000.
Address
Other Address
S.A.M and S.A.E calendar and fees.
Courses are organized on a termly basis. Our term is divided in quarters (Jan to Mar, Apr to Jun, Jul to Sep, Oct to Nov). Payment for lessons will be paid in advance on a quarterly on monthly basis.
Please select preferred payment method.
Rows Monthly fee payable in advance Termly fee payable in advance Family discount (15% discount per additional student)
Maths 1 2 3
English 4 5 6
Maths & English 7 8 9
Banking details:

Bank: FNB
Account name: SAM XXX
Account nr: XXXX
Branch Code: XXXX
Reference: Child's name and surname
I understand one month’s notice must be given to SAM prior to withdrawal of a student.
COVID19
SAM Trainers will be providing the option of online assistance only during the COVID19 lockdown.
The student will be attending classes.
Should be Empty:

Rows	Monthly fee payable in advance	Termly fee payable in advance	Family discount (15% discount per additional student)
Maths	1	2	3
English	4	5	6
Maths & English	7	8	9

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Student Registration Form