Tim Brown Electrical Services Online Application Form

SECTION A: ADMINISTRATIVE INFORMATION

Your Name*:

Your Email*:

Student Number

Date of Registration:

Preferred Campus (required)

Learner Category (required)

Course Type (required)

Does the learner require accommodation? (required)
YesNo

How did the learner know about TIM BROWN?

Learner PHOTO (max size 1MB)

SECTION C: DECLARATION FOR FOREIGN STUDENTS

Have you secured a Study Permit yet with TIM BROWN?YesNo

If you answered Yes above, please provide your study permit No.

Expiry Date of the study permit

Do you have any disabilities that may require any help?YesNo

If Yes, describe the nature of the disability:

SECTION D: YOUR CONTACT INFORMATION (only Student’s contact information)

Cell Phone:*

Home Tel: (if any):

Work Tel: (if any):

Physical Address: Code:

Email Address:

Name of next-of-kin to contact in case of emergencies:*

Contact Number:*

Relationship to Student:*

SECTION E: COURSE INFORMATION

Course Enrolled for:

Course Duration:

Commencement Date:

SAQA Qualification ID Number:

National Diploma: DHET

SETA

N.Q.F. Level:

Declaration of oath for confirmation of having received complete information regarding the course enroled/registered for by the learner (full name)

with ID Number:*

hereby declare that I have been explained the details of the course that I have chosen to enroll for TIM BROWN and that
I fully understand the SAQA ID and NQF level of this course.

SECTION F: RECORD OF LEARNER’S PREVIOUS ACADEMIC ACHIEVEMENTS

Matric Subjects / “A” Levels / “O” Levels / Unit Standard titles

Grade / SAQA I.D.

Final Grade / Symbols / Pass levels

SECTION G: Declaration

Declaration of oath for having submitted accurate information regarding previous academic achievements.
I declare that to the best of my knowledge, the information I have provided is correct and I understand that any incorrect or misleading information will invalidate my application for registration or admission. I also undertake that, if admitted, I will abide by and fully conform to the rules and regulations as laid down by the council of TIM BROWN.

Applicant’s Signature:*

Date:

Place:

SECTION H: FEES PAYMENT INFORMATION

Payment Plan A: (Cash Option)

Registration fees = Paid on:

Tuition fees = Paid on:

Payment Plan B: (Monthly Installment’s Option)

Registration fees = Paid on:

Tuition fees = Paid on:

Installments of R

From:

To:

What is your preferred payment type? Bank DepositDebit / Stop Order

SECTION I: PARTICULARS OF PARENT / SPONSOR / GUARDIAN / COMPANY RESPONSIBLE FOR PAYMENT OF LEARNERS

Full Name and Surname:

or Full Company Name:

Identity Number: or Company Reg No.:

Relationship of Sponsor to Learner: eg: Brother / Employee etc.

Physical Address: (Sponsor / Parent) Code:

Residential Address:(Sponsor / Parent) Code:

Sponsor’s / Parent’s Contacts: Tel (work): Cell:

Sponsors / Parent’s declaration of oath for being liable for Learner’s Fees payment (full names)
with ID number

hereby declare that the information given above is correct to the best of my knowledge. I hold myself / company responsible for the full payment of all the learner’s fees due. I also confirm that I have read and understood the enrolment terms and conditions in this contract and therefore agree to be bound by them.

Signature: (your name)

Date:

SECTION J: LEARNER’S WORK DETAILS (Only to be completed by learners paying their own fees)

Cell Phone: (your name)

Tel (Home):

Tel (Work):

Physical Address: (your name) Code:

Email Address:

Period spent at current employment:

Position held at work:

Employment Status:

I (full name) with ID Number:

hereby declare that the information given above is correct to the best of my knowledge. I hold myself responsible for the full payment of all the fees due. I also confirm that I have read and understood the enrolment terms and conditions in this contract and therefore agree to be bound by them

SECTION K: TERMS AND CONDITIONS OF REGISTRATION.

1. All registration fees, first installments and fees due are required up-front and non-refundable.
2. The student’s failure to attend classes for whatever reason shall in no way entitle him or her to a reduction on fees, nor will it exclude him or her or other signatories to this document from full liability for the payment of fees and other charges.
3. Students who withdraw from TIM BROWN must comprehend that withdrawal from a course from the institution does not exonerate them from their financial obligations to the institution. Students must initate the process in their respective academic department and follow the necessary procedures.
4. The right to attend classes and write exams is not transferable.
5. TIM BROWN will have the right to alter all time-tables, course commencement and completion dates, where and whenever necessary as well as holiday and vacation durations.
6. TIM BROWN reserves the right to create and apply rules, including due performance; the student hereby agrees to be bound by all such rules.
7. TIM BROWN reserves the right to exclude the student from classes and examinations as it may deemed necessary without in any way detracting from the right of recovering the fees payable by the student to TIM BROWN ; and to withhold a student’s examination results or to dismiss him or her failing to pay all or part of required fees or failing to comply with any institutional rules or terms of this contract.
8. The student and other signatories hereby agree to pay all tuition and other fees whenever they fall due to TIM BROWN without any further notice being issued. Should TIM BROWN institute legal action against a fees defaulter, the liability of all the costs involved will fall on the Signatories to this contract other than TIM BROWN , jointly as well as severally.
9. Where tuition fees I s p ayable to TIM BROWN in installments, failure to pay any single installment in time will result in the full balance becoming immediately due and payable without further notice.
10. Tuition fees payable to TIM BROWN do not include College membership fees, examination fees, stationary or other items. Where fees for external exams and study materials are not known in advance, the student hereby agrees to accept the quotations or changes thereof whenever made in the course of the study programme. Furthermore, it shall be the responsibility of the student to bear the cost of transport for study trips, stationary and any other specialised consumables used during the course.
11. External assessments and or exams are compulsory in all our programmes. The student is responsible for ensuring that he/she has been properly registered with the relevant external institute or examining body where applicable, in time, and that he/she has been registered for the correct or relevant examination with such an institute or exam body.
12. The student’s failure to register or write examination for whatever the reason shall in no way entitle him / her to any sort of reduction in tuition fees, nor will it absolve him / her from full liability for the payment of tuition fees due.
13. No relaxation, variation or indulgence granted by TIM BROWN to other signatories hereto in respect of this agreement shall constitute waiver of any rights vested in TIM BROWN in terms hereof.
14. TIM BROWN shall be deemed to include any branch of its Company or any other juristic person to whom the rights and obligations of TIM BROWN, as contained herein may be caded / assigned.
15. In addition to these terms of registration, the signatories further agree to abide by TIM BROWN enrollment terms and conditions and the Student’s Code of conduct as well as the Student’s residence rules and regulations which are in line with the Constitution.
16. Students not satisfied with the institution’s grievance procedures or training programmes should forward their concerns to either QCTO telephonically (012) 003 1800 or the Department of Higher Education and training at 012 312 5027.
17. Fraud cases including altering information on deposit slips, exchanging fees cards are criminal cases and will be reported to the Police and may lead to suspension / discontinuation of a learner from the study programme.
18. The student will not receive any refund of tuition and fees paid in advance if TIM BROWN discontinues a course / programme within a period of time a student could have reasonably completed it, except that this provision shall not apply in the event the college ceases operation.
19. Note that with all refunds, students are obliged to provide TIM BROWN within 20 business days’ notice in writing or other recorded means, of cancellation of fixed term agreement. Reasonable penalties may apply.

I have read, understood and abide by the terms and conditions of registration as stipulated in the section above.

Signature of Parent / Guardian:Date: Place:

Signature of Applicant: Date: Place:

Student Advisor’s Name:Date: Place:

Attachments

Certified copy of student’s ID document *
mandatory and to be certified

Proof of payment (Application Fee) *
mandatory

Copy of financial sponsor ID document

Copy of latest results

Proof of residential address

Your Message (if any)