2011 APPLICATIONS ARE CLOSED. OFFERS OF PLACE - 14 MAY. No application will be processed without proof of payment of deposit.
NUMERICAL INFORMATION: Please insert dashes (-) not spaces between digits e.g. Country Code (254) + Area Code(2) + (679694) Telephone Number should read 254-2-679694
* Required fields
Applicant Details
Surname:	*		Given (First) Names:	*
Proposed Date of Entry:	Jan Feb Mar Apr MayJun Jul Aug Sep Oct Nov Dec 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030		Into Grade:	8/MHS E Block 9/MHS D Block 10/MHS C Block 11/MHS B Block 12/MHS A Block
Date of Birth:	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2010 2009200820072006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990		Present School:
Country of Birth:			Home Language:
ID/Passport No.			Religious Denomination:
Please indicate how you heard about Michaelhouse:
Please choose... Recommended by a friend Attendance at a promotional event Family connection to Michaelhouse Other
If you chose Family Connection above, please complete the following:
Relationship:	First Name & Surname:		Year Left Michaelhouse:
Father Grandfather Uncle Brother
Relationship:	First Name & Surname:		Year Left Michaelhouse:
Father Grandfather Uncle Brother
Parent/Guardian Details
Father			Mother
Surname:			Surname:
Title:			Title:
First Name:			First Name:
ID/Passport No.			ID/Passport No.
Marital Status:	Please choose... Single Married Divorced Widowed		Marital Status:	Please choose... Single Married Divorced Widowed
Home Address:			Home Address:
Postal Address:			Postal Address:
Post Code:			Post Code:
Home Tel. No.			Home Tel. No.
Work Tel. No.			Work Tel. No.
Fax No.			Fax No.
Cellphone No.			Cellphone No.
Email Address:			Email Address:
Company Name:			Company Name:
Occupation:			Occupation:
Position:			Position:

This application will be processed on receipt of the R750 registration fee made payable to "Michaelhouse".

Please e-mail a copy of the internet banking receipt to us or fax a copy of the deposit +27 (0) 33 234 1120

Banking Details:
Michaelhouse
Standard Bank
Pietermaritzburg Branch
Branch Code: 05752500
Account: 052211002

BLOCK This is the year of study that a pupil is in. "A Block" boys would be Standard 10, Grade 12, Year 12 or Matric, and "E Block" boys would be Standard 6, Grade 8 or Year 8. A Blockers are usually 17 or 18 when they finish at the end of the year in December. E Blockers are usually 13 or 14 when they enter Michaelhouse.