Mavuluma Adventist Private School

Primary (Grade R–7) Application Form

Application Fee Notice

Before submitting this application, please pay the N$50 application fee and upload proof of payment (deposit slip / bank transfer receipt) as part of your application below.

Bank Details — Application Fee
Bank Name: Bank Windhoek
Account Name: MAPS
Account Number: CHK 8005005182
Branch Name: Katima Mulilo
Branch Code: 482273
Reference: Learner's name and Grade

Please remember to attach proof of payment as one of your document uploads when you apply.

Details of Pupil

Surname*

First Names*

Date of Birth*

Gender*

Home Language*

Other Languages

Grade Applied For*

Previous School (if any)

Siblings at Our School

Medical Information

Doctor's Name

Doctor's Phone

Allergies or Disabilities

Additional Medical Info

Parent / Guardian Details

Father's Full Name*

Father's ID / Passport*

Mother's Full Name*

Mother's ID / Passport*

Guardian's Full Name

Guardian's ID / Passport

Residential Address*

Postal Address

Home Phone

Work Phone

Father's Cell*

Mother's Cell*

Account Holder Name*

Email Address*

Denomination / Church

Employment Details

Father's Employer

Mother's Employer

Guardian's Employer

Document Uploads

Passport Photo*

Birth Certificate*

Parent ID Documents*

Proof of Residence*

Contractual Agreement

Contract Date*

Contract Place*

Signature*

I accept the contract*

Yes No

Indemnity & Consent

Outing Consent*

Yes No

Parents/Guardian Signature*

Witness Name*

Witness Signature*

Date Signed*

Place Signed*

I accept the indemnity*

Yes No

i consent to first aid being adminstered to my child in an emergency*

Yes No

Financia Obligation

I accept the Financial Obligation*

Yes No

Parent Full Name*

Parent ID Number*

Learner Name*

Learner Grade

Signature*

Date Signed

Application Fee Proof of payment

Proof of payment*