PrefixMr.Mrs.Ms.Mx.MissDr.Prof.First Name *Middle NameLast Name *Street Address *Apartment, suite, etcCITY *State/Province *ZIP / Postal Code *Country *AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua & BarbudaArgentinaArmeniaArubaAscension IslandAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCaribbean NetherlandsCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong Kong SAR ChinaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao SAR ChinaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint HelenaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSouth KoreaSouth SudanSpainSri LankaSt. BarthélemySt. MartinSt. Pierre & MiquelonSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyriaSão Tomé & PríncipeTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTurks & Caicos IslandsTuvaluU.S. Virgin IslandsUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis And Futuna IslandsWestern SaharaYemenZambiaZimbabweEmail Address *Confirm Email Address *PHONE *CELLAGE *DATE OF BIRTHHOME LANGUAGEAfrikaansEnglishisiNdebeleisiXhosaisiZuluSesothoSetswanaXitsongaTshivendaSiswatiSepediOther (please specify)OTHER (HOME LANGUAGE)GENDERMALEFEMALEPREFER NOT TO SAYDo you have any disability or chronic condition (physical ,visual ,auditory, cognitive, mental, emotional, or other) that substantially limits one or more of your major life activities, including mobility, communication, and learning?YESNOI PREFER TO SELF-DESCRIBEI DON'T WISH TO ANSWERSELF-DESCRIPTIONHIGHEST GRADE PASSEDYEAR COMPLETEDHIGHEST QUALIFICATIONNo SchoolingSome Primary SchoolCompleted Primary School (Grade 7)Some High School (Grade 8–10)Grade 10 (Form 3)Grade 11 (Form 4)Grade 12 (Matric)Senior Certificate (Completed Matric)ABET Level 1–4National Certificate (Vocational)N1 CertificateN2 CertificateN3 CertificateNCV Level 2NCV Level 3NCV Level 4DiplomaHigher CertificateAdvanced CertificateNational DiplomaBachelor’s DegreeHonours DegreeMaster’s DegreeDoctorate / PhDOther (please specify)OTHER (HIGHEST QUALIFICATION)NAME OF SCHOOLOCCUPATIONCOURSE LIST Course Title Credits NQF Level Requirements Duration Training Fees Occupational Certificate: Poultry Farmer 226 5 Grade 12 2 Years R130 174 Occupational Certificate: Livestock Supervisor 112 3 Grade 10 1 Year R58 828 Occupational Certificate: Nursery Person (Garden Center Supervisor) 85 3 Grade 10 1 Year R58 828 Occupational Certificate: Landscape Designer 280 5 Grade 12 2 Years R130 174 Occupational Certificate: Mixed Crop and Livestock Farmer 197 5 Grade 12 2 Years R130 174 SELECT ONE *Occupational Certificate: Poultry FarmerOccupational Certificate: Livestock SupervisorOccupational Certificate: Nursery Person (Garden Center Supervisor)Occupational Certificate: Landscape DesignerOccupational Certificate: Mixed Crop and Livestock FarmerRooms - All Sharing, Inclusive of Three Meals and LaundryACCOMODATION REQUIREDYESNOACCOMODATION PAYMENT STRUCTURE AVAILABLE *1st Year Accomodation – R2,500 Deposit – R2,750 Monthly – R32,750 Full YearNOTE Our 12 months cycle period is from February to January the following year. Fees are payable from February to December.The accommodation contract is binding for twelve (12) Months. Transport Charged @ R 1920.00pm for all leaners residing In Brakpan Accommodation. Brakpan accommodation is subject to campus accommodation being full. Registration Fee is R1100.00 (Non-Refundable). Accommodation Deposits refund only eligible to parties who stayed for the duration of the contract. Meals are excluded on Accommodation. All fees are payable to the following banking details: Account name: EKURHULENI AGRICULTURAL COLLEGE (PTY) LTD Bank: FIRST NATIONAL BANK Type of account: CHEQUE ACCOUNT Branch code: 210243 Account number: 62853779620 Ref: STUDENT NAME & SURNAME PrefixParent/GuardianMr.Mrs.Ms.Mx.MissDr.Prof.First Name *Parent/GuardianMiddle NameParent/GuardianLast Name *Parent/GuardianStreet Address *Apartment, suite, etcCity *State/Province *ZIP / Postal Code *Country *AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua & BarbudaArgentinaArmeniaArubaAscension IslandAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCaribbean NetherlandsCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench South TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island And Mcdonald IslandHondurasHong Kong SAR ChinaHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao SAR ChinaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestinian TerritoriesPanamaPapua New GuineaParaguayPeruPhilippinesPitcairn IslandsPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint HelenaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and South SandwichSouth KoreaSouth SudanSpainSri LankaSt. BarthélemySt. MartinSt. Pierre & MiquelonSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyriaSão Tomé & PríncipeTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad & TobagoTunisiaTurkeyTurkmenistanTurks & Caicos IslandsTuvaluU.S. Virgin IslandsUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of America (USA)UruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWallis And Futuna IslandsWestern SaharaYemenZambiaZimbabwePhone *Email Address *Confirm Email Address *OCCUPATIONWHO WILL BE RESPONSIBLE FOR PAYMENTSTUDENTSTUDENT'S PARENT/GUARDIANAPPLICATION PROCESS: Complete the application form Pay the application fee of R350.00 (Non-refundable) Attach recently certified copy of ID and Certifications College liaises with you to determine application status If application is successful, the College will liaise with you on the registration process Registration Fee: R1100.00 (NON-REFUNDABLE) All fees are payable to the following banking details: Account name: EKURHULENI AGRICULTURAL COLLEGE (PTY) LTD Bank: FIRST NATIONAL BANK Type of account: CHEQUE ACCOUNT Branch code: 210243 Account number: 62853779620 Ref: STUDENT NAME & SURNAME ID COPY (STUDENT) *Choose FileNo file chosenDelete uploaded fileID COPY (PARENT/GUARDIAN) *Choose FileNo file chosenDelete uploaded fileLATEST QUALIFICATIONChoose FileNo file chosenDelete uploaded filePROOF OF PAYMENT *Choose FileNo file chosenDelete uploaded fileCOMPREHENSION AND ACCEPTANCEI hereby agree to be solely liable for full fees due to Ekurhuleni Agricultural College should I be accepted. I further agree that failure to attend lectures will not reduce my liability for the full tuition fees for the course.I AGREE TO THE TERMS AND CONDITIONS *YESAPPLICANT'S SIGNATUREPARENT/GUARDIAN SIGNATUREDATE OF APPLICATIONSUBMIT