APPLICATION FORM

*FOR OFFICE USE

STUDENT NUMBER:

GENERAL INFORMATION AND INSTRUCTIONS

1. Please complete this form in full, in block letters, to prevent unnecessary delays.
2. Remember to Initial each page and to sign, in full, on page 10.
3. Certified copies of the following documents must accompany this form: Identity Document or Passport.
4. Tertiary Academic Qualification Certificate and Transcript, if you have studied at another higher education institution.
5. Any other required documents as per the qualification admission requirements – refer to the CEA website (www.cea.co.za)
6. Banking Details: Name of Account Holder: Career Excel Academy (PTY) LTD, Bank: Standard Bank, Branch Code:
051 001 (Universal), Account number: 371 686 881, Please use student/ID number as reference
7. Acceptance for all programmes will be subject to academic selection.
8. Please send your completed form to:
Career Excel Academy (PTY) LTD
ATT: The Applications Office
Address: 140 Bauhinia Street, Highveld, Techno Park, Centurion, 0169
Phone number: +27 (0) 71 261 8582 or 012 884 0198
Email: [email protected] or [email protected]

PERSONAL DETAILS

FIRST NAME:

SURNAME:

ID NUMBER:

CELLPHONE NUMBER:

HOME ADDRESS:

EMAIL ADDRESS:

NATIONALITY:

CITIZEN RESIDENT STATUS: SA CITIZEN DUAL (SA & OTHER) OTHER

SPECIAL NEEDS STATUS If you have a disability or special needs requirement, please complete the information below

YES, I HAVE A DISABILITY OR SPECIAL NEEDS REQUIREMENT NONE

Please rate your disability or special need on the following scale for each one of the categories listed below.
1.No difficulty 2. Some difficulty 3. A lot of difficulty 4. Cannot do at all 5. Cannot yet be determined

SEEING x1 x2 x3 x4 x5

HEARING x1 x2 x3 x4 x5

COMMUNICATION (SPEECH) x1 x2 x3 x4 x5

PHYSICAL x1 x2 x3 x4 x5

EMOTIONAL x1 x2 x3 x4 x5

INTELLECTUAL (LEARNING) x1 x2 x3 x4 x5

Please indicate any specific requirements for examination purposes (e.g. wheelchair access, etc)

DEMOGRAPHIC DETAILS Compulsory Information required by the Department of Higher Education (DHET)

SOCIO ECONOMIC STATUS: EMPLOYED UNEMPLOYED, SEEKING WORK UNEMPLOYED, NOT

SEEKING WORK

STUDENT/SCHOLAR PENSIONER/RETIRED UNABLE TO WORK

(DISABLED)

GENDER: MALE FEMALE

DO NOT WISH TO DISCLOSE

RACE: AFRICAN COLOURED INDIAN/ASIAN

WHITE OTHER

HOME LANGUAGE: AFRIKAANS ENGLISH TSHWANA ZULU

OTHER

If “other” is selected at Home Language, please specify

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ACADEMIC HISTORY Secondary and Tertiary Education

HIGHEST GRADE ACHIEVED: GRD 12 IN PROGRESS GRD 12 COMPLETED

OTHER, SPECIFY

YEAR COMPLETED:

SCHOOL ATTENDED:

SCHOOL PROVINCE

TERTIARY QUALIFICATION ACHIEVED: CERTIFICATE DIPLOMA DEGREE POSTGRAD MASTERS

OTHER

TERTIARY QUALIFICATION NAME:

TERTIARY INSTITUTION ATTENDED:

DURATION (FROM-TO): YEAR COMMENCED YEAR

COMPLETED

NEW PROGRAMME DETAILS What would you like to study?

QUALIFICATION TYPE: HIGHER CERTIFICATE

NAME: HIGHER CERTIFICATE IN CONSTRUCTION QUANTITY SURVEYING

HIGHER CERTIFICATE IN FACILITIES MANAGEMENT

EXAMINATION VENUE

CENTURION CAMPUS: 140 Bauhinia Street, Highveld, Techno Park, Centurion, 0169

STUDY MATERIAL/ TEXTBOOKS Indicate your preferred method of delivery.

POSTAL ADDRESS:

POSTAL CODE:

DELIVERY ADDRESS:

TOWN: POSTAL CODE:

DELIVERY METHOD THE COURIER GUY

CAMPUS COLLECTION: CENTURION

OTHER PLEASE SPECIFY__________________________________________________

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DHET ACKNOWLEDGEMENT/ DECLARATION As required by the DHET

The Department of Higher Education (DHET) requires that students complete an acknowledgment or
acceptance, detailing their under- standing of the higher education qualification/s on which they are
admitted.

I am fully aware that the programme I have enrolled for (select the qualification from the following
list) is the:
1.Higher Certificate in Construction Quantity Surveying (SAQA ID 117871) or
2. Higher Certificate in Facilities Management (SAQA ID 117869)

PROGRAMME NAME:

I, (Full Name and Surname) ID/Passport Number)

am fully aware that the programme that

I am enrolling for with SAQA ID is registered with the department of Higher

Education and Training to Career Excel Academy, as indicated on the registration certificate dated 28

October 2022

Student Signature: Date:

CEA Signature: Date:

Name:

Designation:

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APPLICANT PRIVACY NOTICE AND DECLARATION

To administer your application, it is necessary for CAREER EXCEL ACADEMY to process some of your personal information,
including but not necessarily limited to: Identifying information, contact information (including address), demographic details,
academic details regarding prior learning, employment details where applicable and in some cases, supporting documentation.
Should your application be successful, and you are registered, CAREER EXCEL ACADEMY will also process information on your
academic progress, assessment of learning and correspondence.

CAREER EXCEL ACADEMY respects the right to privacy and will only process your personal information for the following
purposes:
• delivering academic services (including but not limited to administering student and prospective student admissions,
enrolment, registration, education, engagement, and validation of qualifications);
• providing information on additional academic service offerings;
• fee payment or collection;
• any additional purposes to which you consent; and
• as otherwise required by law.

By accepting this privacy notice, you give consent that CAREER EXCEL ACADEMY and its approved representatives may:
• process your personal information for the purposes stated above as well as any other directly related purposes;
• obtain information concerning your academic certificate and/or transcript from any school, university or other
educational institution previously attended and use it to validate your qualifications;
• share your personal information with qualification verification agencies, who in turn may enter your qualification
information into the National Learners Register;
• share your personal information with third party service providers engaged by CAREER EXCEL ACADEMY for the purposes
listed above;
• contact you with information about additional academic service offerings with the option to opt out of further similar
correspondence;
• process as confidential information any health information provided by you for the purpose of accommodating disability or
sick leave;
• process your personal information as needed to meet security requirements, and the requirements of government,
professional bodies and other regulatory authorities; and
• in the event of any reorganization, merger, or acquisition of CEA, your personal information may be transferred as part of
the transaction to the acquirer.

In addition - If successfully admitted as a student of a corporate account:

• You consent to CAREER EXCEL ACADEMY receiving your personal information necessary for the application and
registration process from your employer; and

All applicants – By accepting this privacy notice you also make the following declaration:
• I hereby certify that I will provide information that is correct and complete. I understand that false or incomplete
information will be invalid - date this application.
• Signature denotes agreement of the CAREER EXCEL ACADEMY privacy policy and declaration

STUDENT NAME: SIGNED:

DATE:

In the event of the student being a minor (U18):

I, , the Parent/Guardian of the Student,

hereby accept and give consent to CAREER EXCEL ACADEMY to process any personal or confidential information required for the
purposes outlined above.

SIGNED: DATE:

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TERMS AND CONDITIONS OF REGISTRATION

Registration Agreement entered into between CAREER EXCEL ACADEMY(PTY) LTD, a registered private higher education
institution with the Department of Higher Education and Training under the Higher Education Act, 1997, with registration
certificate number 2022HE07/004 (hereinafter CEA), and the Student.

GENERAL:

1. Binding Registration Agreement

1.1. The Student agrees that by signing this form, a binding Registration Agreement comes into existence between
CEA and the Student .
1.2. It is recorded that the Registration Agreement that comes into existence pursuant to the successful registration at CEA
is concluded for 1 (one) academic period only and the Student will be required to re-register for the next academic
period. An academic period is a full academic year (maximum 12 months),
1.3. It is the Student’s responsibility to fully read, understand and agree to all the terms and conditions of this
Registration Agreement. By agreeing, the Student confirms that they possess a full understanding of all the terms
and conditions herein, and willingly accepts all such terms.

2. Programme and modules

2.1.1. The Student agrees that he/she has availed him/herself of the details of the particulars of the qualification as
well as the curriculum of the programme and module(s) for which the Student is registering. Full curriculum
details are available on the CEA’s Learning Management System (Moodle).
2.1.2. CEA shall be entitled, at its sole discretion, to vary the module syllabi, to alter the methods by which the programme
is delivered, to alter timetables or course commencement dates, or to discontinue the programme (subject to teach-
out provisions) at any time, without prior notification and without furnishing reasons therefore.
2.1.3. CEA shall have the right to alter the location of delivery of the programme, with reasonable notice.
2.1.4. CEA shall have the right in its sole discretion, to postpone or cancel any programme or course initially advertised
and offered, based on insufficient demand.

3. Cancellation of studies
3.1.1. The Student reserves the right to cancel this Registration Agreement.
3.1.2. Cancellation of registration must be done in writing and in accordance with the administrative process prescribed.

4. Information
4.1.1. The Student warrants that all information provided to CEA is true and correct
4.1.2. In the event of the Student’s registration being cancelled as a result of false information, the Student will not be entitled to
a refund.
4.1.3. The Student guarantees that all supporting documents provided are accurate copies of the original documents and if
proved otherwise CEA reserves the right to cancel the Registration Agreement by written notification without redress.

1. Codes, rules and regulations

1.1.1. The Student hereby undertakes to familiarise him/herself with the codes, rules and regulations of CEA and
undertakes to abide by the codes, rules and regulations contained in the following documents or any other
directive issued, from time to time, by the institution;
• Student Code of Conduct
• Website Privacy and security policy
• CEA’s Health and Safety Regulations
1.1.2. CEA reserves the right to amend its codes, rules and regulations as often as and when it deems necessary to
do so, without giving prior notice to the Students.
1.1.3. CEA reserves the right to exclude the Student from assessments; to suspend a Student’s studies or to expel a
Student from the institution for failing to comply with any rules of CEA, as communicated in official
documentation.

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2. Intellectual property ownership
2.1.1. The Student hereby cedes and assigns to CEA any existing, future or contingent copyright or any other
intellectual property right that may arise from any incomplete or completed work, including, without limitation,
any creative output, any paper, article, assignment, dissertation, thesis or minor-dissertation, that may in any
way whatsoever have originated or originate from any study or research project the Student may have
undertaken or have launched or may undertake or launch at CEA, irrespective of whether such work has been
or may be accepted for examination, in accordance with national legislation and CEA’s policy related to
intellectual property.

3. Legal declaration of indemnity

3.1.1. Neither CEA nor any official employee or representative of CEA acting in his/her capacity as such shall be liable
for any damage arising out of:
• The death, bodily harm, loss of health or illness of any Student howsoever caused; and
• The destruction of or damage to any property owned by or in the custody of any Student,
howsoever caused.
3.1.2. The Student hereby indemnifies CEA against any claim made against CEA in respect of any damage arising
out of the fault of the Student.
3.1.3. CEA shall ensure that its property, facilities and equipment are safe, and that Students are given proper
instructions or warnings for their use.

4. Extraordinary circumstances
4.1.1. In cases of extraordinary circumstances beyond the control of CEA, CEA reserves the right to close the institution
temporarily or to make such alternative teaching arrangements as are deemed feasible.
4.1.2. Whilst every effort will be made to resume operating as soon as possible, no warranties are made in this regard
and no refund in fees will be made and this Registration Agreement will remain in full force and effect.

5. Additional terms
5.1.1. The Student gives permission that details of their academic performance, including but not limited to assessment
results, as well as information on conduct may be shared by CEA with the Co-principal debtor(s), as indicated in
Part B of this Registration Agreement.
5.1.2. No relaxation, variation or indulgence granted by CEA to the other signatories hereto in respect of this
Registration Agreement shall constitute a waiver of any rights vesting in CEA in terms hereto, and no reliance
may be placed by the Student or other signatory hereto or any statement or representation not contained herein.
5.1.3. All the provisions of this Registration Agreement shall be severable, and no provision shall be affected by the
invalidity of any other provision of this Registration Agreement.
5.1.4. This agreement shall apply together with any other agreement that you enter into with CEA. In the event of a
conflict, the agreement entered into last will apply.
5.1.5. CEA confirms that all official communication will take place through the Student’s allocated CEA student number
via its platforms. The student consents to the student’s e-mail address serving as domicilium citandi et executandi
for the purpose of serving legal documents, including statements of account. The statement of account also
serves and constitutes a demand for payment.

6. Breach and termination

6.1.1. If the Student or Co-principal Debtor (as indicated in Part B) breach this Registration Agreement, or any other
CEA codes, policies, rules or regulations, CEA may elect to send them a notice stating that they are in breach.
6.1.2. If the Student remains in breach for a period of seven (7) days after receiving notification that CEA requires the
breach to be remedied, then CEA shall be entitled, without prejudice to its rights and at its sole discretion, in line
with the CEA policies and procedures, cancel the Student’s registration and this Registration Agreement.
6.1.3. Depending on the nature of the breach the Student may be required to leave the institution immediately.
6.1.4. CEA shall have no obligation to refund any fee if the Student remains in breach despite the written notice

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FEES AND FUNDING

1. Liability for fees and costs

1.1.1. The Student hereby binds him/herself to CEA, jointly and severally with Co-principal Debtor(s) where
applicable, for the payment of all fees and charges that become due by them to CEA as a result of registration
in terms of this Registration Agreement.
1.1.2. The Student shall not be entitled for any reason whatsoever to withhold or defer payment stipulated in this
Registration Agreement.
1.1.3. CEA reserves the right to charge interest on late payments at a maximum rate of 2% per month on all overdue
accounts.
1.1.4. CEA reserves the right to cede the collection of fees to a finance house or other institution. In this regard, the
term “CEA” shall include such cessionary/ies. In such a case, the payment terms of the finance house will
apply.
1.1.5. The Student hereby agrees to be held liable for all legal costs on a scale as between attorney and client,
including collection of commission charges and tracing agent costs from the date of hand over by CEA to their
attorneys for the recovery of any outstanding fees.
1.1.6. In the event of a Student defaulting on payment of fees, CEA reserves the right to: withhold the Student’s
assessment results;
• withhold the qualification certificate and academic transcript of a graduating Student,
and refuse the Student participation in the CEA graduation ceremony;
• refuse to register a Student for any further modules or courses;
• recover all outstanding amounts from the Student, as per this Registration Agreement.
• In the event of a Student defaulting on payment of fees on a year module, CEA reserves the
right to cancel the Student’s registration and exclude the Student from access to CEA’s premises
and systems during the academic year, unless the Student has entered into a formal, approved
payment arrangement with CEA.
1.1.7. No reduction in fees or refund will be applicable where Students do not attend class, or otherwise do not
take part in the prescribed learning activities of the institution or are suspended for a period of time.

2. Tuition fees

2.1.1. Tuition fees include the following, for the academic period registered for:
• Study material, textbooks, unless otherwise specified;
• Assessments and assessment facilities;
• Access to the relevant and applicable physical and online campus facilities of CEA;

2.1.2. The following are expressly not covered by tuition fees and may be charged separately by CEA:
• Stationery, consumables and specialised equipment kits, where applicable;
• Any levies;
• Any fees related to excursions, such as transport, food, entrance fees, and the like;

3. Cancellation fees
3.1.1. The deposit and balance of the tuition fees are refundable to a contact learning Student cancelling their
first semester of registration, as follows:
• 100% minus the prescribed withdrawal fee, if cancelling on or before fourteen (14)
calendar days from the first day of the CEA academic semester registered for; or
• 0%, if cancelling later than fourteen (14) calendar days from the first day of the CEA
academic semester registered for.
3.1.2. The deposit and balance of the tuition fees are refundable to a contact learning Student cancelling their
second/further semester of registration, as follows:
• 100% minus the prescribed withdrawal fee, if cancelling on or before seven (7) calendar
days from the first day of the CEA academic semester registered for; or
• 0%, if cancelling later than seven (7) calendar days from the first day of the CEA
academic semester registered for.

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 PART B: CO-PRINCIPAL DEBTOR (If applicable)

1. General
1.1.1. The Co-principal Debtor hereby bind(s) themselves to CEA, jointly and severally with the Student and/or
other Co-principal Debtors where applicable, for the payment of all fees and other charges due by them to
CEA in terms of this Registration Agreement.
1.1.2. The Co-principal Debtor agrees that CEA may recover, at its discretion and in no specific order of
preference, such monies in full from either the Student or the Co-principal debtor(s), or in part from both/all
the aforementioned parties.
1.1.3. This Registration Agreement can only be cancelled or withdrawn with CEA’s written permission.
1.1.4. The Co-principal Debtor agrees to the jurisdiction of the Magistrate’s Court, in respect of any legal
proceedings that may be instituted arising from or in respect of this Registration Agreement, notwithstanding
the fact that the amount in dispute may exceed the jurisdiction of the Magistrate’s Court and select as their
domicilium citande et executandi for all purposes the address indicated below.

2. Payer declaration and undertaking

2.1.1. To administer the application, it is necessary for CEA to process some of the Co-principal Debtor’s
personal information, including but not necessarily limited to: Identifying information, biometric
information, consumer credit information, contact information (including address), demographic details,
and employment details where applicable and in some cases, supporting documentation. Provided
that there is no unfair discrimination on the grounds of race, gender, sex, marital status, ethnic or
social origin, colour, sexual orientation, age, language or birth, information pertaining thereto may be
processed.
2.1.2. CEA respects the right to privacy and will only process the Co-principal Debtor’s personal information
for the following purposes:
• fee payment or collection;
• any additional purposes to which the Co-principal Debtor consents; and
• as otherwise required by law
2.1.3. By accepting this privacy notice, the Co-principal Debtor consents that CEA and its approved
representatives may:
• process the Co-principal Debtor’s personal information for the purposes stated above
as well as any other directly related purposes, including cloud storage of your
information outside SOUTH-AFRICA;
• in the event of any reorganization, merger, or acquisition of CEA, the Co-
principal Debtor’s personal information may be transferred as part of the
transaction to the acquirer, whether inside or outside of SOUTH-AFRICA.

AVAILABLE PAYMENT PLAN OPTIONS Please mark with an X

PLAN A: Full payment in advance (one single payment) - R45 950.00

PLAN B: Monthly payments in advance, payable on the first of the month - R5000.00 enrolment
fee thereafter R3900 per month for 11 months

BURSARY If this option is applicable, please provide your Bursary letter

AVAILABLE PAYMENT METHOD OPTIONS Please mark with an X

DEBIT ORDER:

DIRECT EFT:

Page 9 of 12
 ACCEPTANCE OF REGISTRATION AGREEMENT

SIGNED ON THIS DAY OF 20

AT________________________________________________

I, (Student), confirm that I have read the

Registration Agreement and am familiar with the terms and conditions thereof and undertake to hold myself
liable in respect of any claim which CEA may have against the student in accordance with the said
Registration Agreement.

I have full understanding of these, having taken the time to read the Registration Agreement, ask questions
and understand my obligations and responsibilities.

SIGNED________________________________________________

IN EVENT OF THE STUDENT BEING A MINOR (If student is under the age of 18 – U18)

NAME OF PARENT/ LEGAL

GUARDIAN:

IDENTITY NUMBER OF
PARENT/ LEGAL GUARDIAN:

HOME ADDRESS OF
PARENT/ LEGAL GUARDIAN:

EMAIL ADDRESS OF
PARENT/ LEGAL GUARDIAN:

SIGNED ON THIS DAY OF 20

AT________________________________________________

I, __________________________________________the Parent/Guardian of the Student hereby consent to the

Student entering into this Registration Agreement, as outlined above, with CEA.

SIGNED:

Page 10 of 12
PART B: CO-PRINCIPAL DEBTOR (IF APPLICABLE) (To be completed by the Parent of a minor Student, and/or by any other party who
takes responsibility for the payment of the student’s fees in terms of this Registration)

FULL NAME / COMPANY

(SPONSOR) NAME:

ID / COMPANY REG. NO:

COMPANY VAT NUMBER:

ADDRESS:

EMAIL ADDRESS:

CELL PHONE NUMBER:

ALTERNATIVE PHONE NO:

RACE AND GENDER:

EMPLOYMENT STATUS:

EMPLOYER NAME:

EMPLOYMENT SECTOR:

EMPLOYER ADDRESS:

MARITAL STATUS:

NATIONALITY:

SIGNED ON THIS DAY OF 20

AT________________________________________________

I, hereby bind myself as

surety and co- principal debtor in favour of CEA for all of the obligations of the Student to CEA pursuant
to the entering into of the aforementioned Registration Agreement and declare that the indebtedness of
the Student to CEA secured by me hereunder includes payment by the Student of all sums of money
which are now, or which may at any time hereafter become due and owing by the Student to CEA in
respect of the Registration Agreement, and in respect of any breach by the Student of any terms of that
Registration Agreement.

SIGNED:

Name & signature of the Co-principal Debtor’s Spouse, if married In Community of Property.

Page 11 of 12
NAME:

SIGNED_______________________________________________________

Page 12 of 12