STADIO APPLICATION TO STUDY 2022 SCHOOL OF LAW / SCHOOL OF ADMINISTRATION & NAMIBIA MANAGEMENT / SCHOOL OF MANAGEMENT FOR SAFETY IN SOCIETY - Distance L 7 STUDENTNUMBER: PETE Ht YQLUOLEES GENERAL INFORMATION AND INSTRUCTIONS Please complete ths form in full n block letters, to prevent unnecessary delays. 2. Remember to Initial exch page and to sig, in Full,on page 1), 3. Certified copies of the following documents must accompany this form: + Identity Document or Passport. ‘Marriage certificate, where surname on Academic records differ to ID/Passport Tertiary Academic Qualification Certificate and Transcript, if you have studked at another higher education institution ‘Any other required documents as per the qusiication admission requirements ~ refer tothe Information Pack on the website {http:liwww stadio.ec.z0) + Proof of peyment ~ refer tothe fee schedule on the website www stadio.acza BANKING DETAILS Bank Windhoek, Branch/Branch Code: Windhoek/481972, Name of Account Holder; Stadio Namibia Higher Education Institution (PrY) Ltd, Account Number: 8002481319, Pleate use student/ID number as reference ‘Acceptance for ll programmes will be subject to academic selection. lease send your completed form to: os Windhoek office: Ongwediva office: Phone number:+264 (0) 83 331 0080 Phone number:+264 (0) 83 331 0080 Email: ninfo@stodiol acs einanG@itado.aczledech@rtdio ac Cell +264 (0) 81145 5629 Fax number: +264 (0) 88 655 4571 or 264 (0) 88 655 4573 Eri: helloongwediva@stadio.se20 Postal address: The Registration Department, Private Bag 13026, Fax number: +264 (0) 88 656 1585 Windhoek, Namibia Phypicaladdrst:24 Wagner Street, Windhoek West, Windhoek PERSONAL DETAILS rs wan ees SURNAME eee NAM ID NUMBER: C2cze wea CELLPHONENUMBER 4) OU A Cuct = HOME ADDRESS: ue s 05) aoa 3 EMAIL ADDRESS: “a ee Lew heee rele NATIONALITY: ee ors'pied CITIZEN RESIDENTSTATUS: NAMIBIAN DUAL(SAROTHER) OTHERSTADIO NAMIBIA NTERNATIONAL STUDENT DETAILS PassporTNUMBER, §—§ OpcaQH>— EXPIRY DATE: 23 AT wor COUNTRY OF RESIDENCE: EMG PERMILIEE, STUDY VISA PERMANENT RESIDENCE PERMIT ““OTHER/ NA SPECIAL NEEDS STATUS If you have a disability or special needs requirement, pleate complete the information below YES, | HAVE A DISABILITY OR SPECIAL NEEDS REQUIREMENT \-None Please rate your disability or special need on the following scale for exch one of the categories listed below: |LNo difficulty 2. Some difficulty 3. A lt of difficulty 4. Cannot do at ll 5. Cannot yet be determined 6. Former difficulty, none now SEEING 1 2 2 4 5 6 HEARING 1 2 a 4 5 6 COMMUNICATION (SPEECH) 1 2 3 4 5 ‘ PHYSICAL 1 2 2 4 5 ‘ EMOTIONAL 1 2 2 4 5 6 INTELLECTUAL (LEARNING) 1 2 3 4 5 6 Please indicate any specific requirements for examination purposes (e.g. wheelchair access, etc) DEMOGRAPHIC DETAILS Compulsory Information required by the Department of Higher Education (DHED. SOCIO ECONOMIC STATUS: EMPLOYED \“ UNEMPLOYED, SEEKING WORK UNEMPLOYED, NOTSEEKING WORK PENSIONERIRETIRED __STUDENTISCHOLAR UNABLE TO WORK (DISABLED) HOME LANGUAGE: \ AFRIKAANS ENGLISH DAMARAINAMA HERERO. GERMAN OSHIWAMBO RUKWANGALI SILOSIE OTHER GENDER: MALE Femate DO NOT WISH TO DISCLOSE RACE: AFRICAN COLOURED INDIAN/ASIAN WHITE ‘OTHERSTADIO NAMIBIA Secondary and Tertiary Education HIGHEST GRADE ACHIEVED: GRD 1Z1N PROGRESS: cro 2 comPLeteD OTHER, SPECIFY YEAR COMPLETED: WO ‘SCHOOL ATTENDED: Nerkes Cesr Wal S&cleo) ‘SCHOOL PROVINCE Healan cecgon TERTIARY QUALIFICATION ACHIEVED: CERTIFICATE DIPLOMA DEGREE ——_POSTGRAD MASTERS OTHER TERTIARY QUALIFICATION NAME: TERTIARY INSTITUTION ATTENDED: DURATION (FROM-TO): ‘YEAR COMMENCED ‘YEAR COMPLETED 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? QUALIFICATIONTYPE: 1 UNDERGRADUATE POSTGRADUATE PROGRAMME NAME: Bidanc: in Mencegerent MAJORING IN: Reine ge cowmk Merketine, menecemert MODULE SELECTION AND EXAMINATION DETAILS You ean only register for a maximum of 3 modules per semester MODULE}: Moegenerr Acetee ICMMMCOX HO) MODULE 2: Merkering — Mercegment ICMNU@ 20 MODULES: Cemanie S Tp 818 (20010 ACC) A ECV 106 CidSTADIO NAMIBIA NUE Indie your preferred examination venue “Windhoek *Mariental *Keetmanshoop *Luderits "Rosh Pinah “ *Rundu ‘Ongwediva “Opuwo *Outapi *Katima Mulilo njemund *Gobabis "Walvis Bay *Otjwarongo “Tsumeb PREFERRED EXAMINATION VENUE: LOlncthock. ERIAL Indicate your preferred method of delivery. POSTAL ADDRESS: PoBoe 4Onb® UWein LOnelicck POSTAL CODE a DELIVERY ADDRESS: PROVINCE: POSTAL CODE. DELIVERY METHOD: tea Collect at a Nampost nearest to you. An SMS will be sent once the parcel i ready fr collection, ELECTRONICALLY (EMAIL) ‘Study guides will be made availabe on MySBS and will NOT be posted CAMPUS COLLECTION 24 Wagner Steet, Windhoek West, Windhoek or Ongwedva Office: Marla Mall Shop F20 DHET ACKNOWLEDGEMENT ‘The Department of Higher Education (DHET) requires that students cor standing of the higher education quaifieation/s on which they are admitted. an acknowledgment or acceptance, detailing their under | am fully aware thet the programme Ihave enoled fr (select the qualification from the olloing ist isthe Higher Certificate in Man agement (SAQA ID 117871) or Diploma in Management (SAQA ID 117869) oF Advanced Diplomsin Management (SAQA ID 117865) or Bachelor of Business Adminstration (SAQA ID 117863) or Bachelor of Business Administration Honours (SAQA ID 117864) or Higher Certificate in Paralegal Studies (SAQA ID 117877) or Bachelor of Commerce in Law (SAQA ID 117872) or Bachelor of Laws (SAQA 1D 117873) (LLB) or Diploma in Policing (SAQA ID 117874) or Bachelor of Policing Practice (SAQA ID 117862) or Bachelor of Paling Practice Honours (SAQA ID 117866) or Master of Management (SAQA ID 117867) or Master of Policing Practice (SAQA ID 117868) «¢ Doctor of Management (SAQA DID 117875) or Doctor of Policing (SAQA ID 117876) and that this programme is approved by the Department of Higher Education and Tanng to STADIO (Pty) Ltd sindieated on the registration certifies dated 6 Ortober 2020. procrammeNname Ticker, in Meocegment | ShecntyeS> “ricia Me eeler— (AD/Possport Number) COOK D! COEOA an fll ware that the progam that |r ceavoling for with SAQAID NEA is registered with the department of Higher Education and Training to STADIO, as indicated onthe registration certificate. er locneSTADIO NAMIBIA JOTICE AND DECLARATION To edminster your application, it is necessary for STADIO 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 learing, ‘employment detais where applicable and in some eases, supporting documentation. Should your application be successful and you are regs tered, STADIO wil also process information on your academic progress, atersment of learning and correspondence STADIO respects the right to privacy and wll only process your personal information forthe following purposes: + delivering academic services Gncluding but not limited to: administering student and prospective student admissions, enrolment, regs tration, education, engagement, and validation of qualifications); providing information an addtional academic service offerings; fee payment or collection; any additonel purposes to which you consent; and as otherwie required by lam, By accepting this privecy notice, you give consent that STADIO and ts approved representatives may: ‘+ process your personal information forthe purposes stated above at well at anyother directly related porpotes; ‘+ obtain information concerning your academic certifieate andlor 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 tied party service providers engaged by STADIO 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 forthe 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 STADIO, your personal information may be transferred as part ofthe trans- action tothe acquirer. In addition -IFsuccessflly admitted as student of a corporate account: + You consent te STADIO receiving your personal information necessary forthe application and registration process from your employer, and ‘All applicants ~ By accepting this privacy notice you also make the following declaration: + Thereby certfy thet | ill provide information that i corect and complete. | understand tht false or incomplete information wil wali date this application. + Signeture denotes agreement of the STADIO privacy policy and declaration STUDENTNane: Scere Trela-taee: save, A pare, M1 |ct aoe In the event of the Student being & minor (U18): 4, the Parent/Guardian ofthe Student, hereby accept and give consent to STADIO to process any personal or confidential information required fr the purposes outlined above ‘SIGNED: DATE: aSTADIO NAMIBIA TERMS & CONDITIONS OF REGISTRATION Registration Agreement entered into between STADIO (Pry) Limited, registered private higher educotion institution withthe Depertment of Higher Education ond Training under the Higher Education Act, 1997, with registration certfcate number 2008/HEOO7/004 (hereinafter ‘STADIO); andthe Student. GENERAL: 1. Binding Registration Agreement 14, The Student agrees thatby signing thi form, a binding Registration Agreement comes into existence between STADIO snd the Student but i conditional upon a successful credit assessment in terms of clause 1.3, as maybe applicable 1.2, Ris recorded thet the Registration Agreement that comes into existence pursuant tothe succesful registration st STADION is concluded for 1 (one) academic period only and the Student wll be required to re-register forthe next academic period. Uniess extraordinary circumstances prevail an academic period is either a semester (maximum 6 month) or full academic year nasiurn 12 months), depending on the academic modules registered for. 13. The term "Registration Agreement is accepted provsonlly based on the outcome ofa credit assessment of the Student andlor (Co-principal Debtor, if applicable, and STADIO reserves the right to decline the Student’ registration application iit does not comely ith r meet STADIO' credit grating crite, The todent shal be notified ofthe outcome ofthe credit essessment, if applicable. 14, Itisthe Student's responsibilty to fully rea, understand and agree to all the terms and conditions of ths Registration Agreement. By agresing, the Student confirms that they possess ull understanding ofall the terms and conditions herein, and wilingy accepts all such terms. 2. Programme and modules 21. The Student agrees that helshe has availed him/herself ofthe details of the particulars ofthe qualification aswell s the curriculum of the programme and module(s) for which the Students registering. Full eurieulum details ae available on the STADIO website. 22. STADIO shall be entitled atts sole discretion, to vary the module sli, to alter the methods by which the programme is elivered, to alter timetables or course commencement dates, or to discontinue the programme (subject to teach-out provisions) {at anytime, without prior notification and without furnishing reosons therefore. 23. STADIO shall have the right to alter the location of delivery ofthe programme, with reasonable notice. 24, _ STADIO shall heve the right nits sole discretion, to postpone or cancel any programme or course initially advertised and offered, based on insufficient demand. 3. Cancellation of studies 31. The Student reserves the right to cancel this Registration Agreement. 32, _ Incase ofa cancellation, a reasonable cancelation fee (outlined in clause 15 below) will become payable. 3.3. Cancellation of registration must be dane in writing andin accordance with the administrative process prescribed. 4, Information 43. The Student warrants that all information provided to STADIO is true and correct in every respect and that any fale information ‘provided may lead tothe termination ofthe Students registration at any time and that STADIO may inform others, including but ‘ot limited to, Government agencies and regulatory o professional bodies, of ths fle information. 42. _ Inthe event of the Student's registration being cancelled asa result of false information, the Student wil not be entitled to» refund of any Fes pad and wil be abe to settle the balance of outstanding Fes. 43. The Student guarantees that all supporting documents provided are accurate copes of the original documents and if proved ‘otherwise STADIO reserves the right to cancel the Registration Agreement by written notification without redress. 5. Transfer of studies Si. The Student i entitled under certain circumstances to transfer his/her tition to anather STADIO campus where the specific programme ison offer orto another mode of delivery, if available. 5.2. The prescribed administrative processes must be followed, and an administration fee may become payable. 53. The consent to transfer wl be at the sole discretion of STADIO.STADIO NAMIBIA 6 Codes, roles and regulations 61. The Student hereby undertakes to familiarize him/hercelf with the codes, rules and regulations of STADIO and undertakes to abide by the codes, rules and regultions contained in the following documents or any other directive issued, from time to time, by the institution; GAN. Student Code of Conduct 642. Faculty/School/Programme rule books 643. Website Privacy and security policy 614, STADIO’s Health and Sofety Regulations 62. STADIO reserves the right to amend its codes, rules and regulations as often a ving prior notice to the Students 63. STADIO reserves the right to exclude the Student from assessments; to suspend a Student's studies orto expel» Student from the institution for Failing to comply with any rules of STADIO, as communicated in official documentation. 64, Ifthe Student is expelled or dismissed from an institution or organisation other than STADIO which the Student i required to attend or bea member of as part ofthe progremme, STADIO shall be entitled to end this Registration Agreement immediately bby written notice tothe Student. ind when it deems necessary todo zo, without 7. Intellectual property onnership 71, The Student hereby cedes and assigns to STADIO any existing future or contingent copyright or any other intellectual property «ight that may arise from any incomplete or completed wor, including without imitation, any crentive output any paper, article, assignment, dissertation, thesis or minor-dssertation, 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 STADIO, ltrespeetve of whether such work has been or may be accepted for examination, in accordance wth national legislation and ‘STADIO's policy related to intellectual property. ie 81. _ NatherSTADIO nor ony offi employe or representa of STADIO acingin ler capacity ar such halle abe fer any arene LT dest by rl ban nso ay Sider ewan corded 812, _Thedesteton of or dnmogeto any property owned by oin the custody oF any Stent howscever cused 82, The Stodnt hereby ndrmifes STADIO again any cin rede agent STADIOinrepet of any damage arsng oto the ful ofthe Studer. 83, STADIO shal enue that ts proparty fetes and eupment ae safe and tht Stents verings other om ven proper instructions or 9. Extraordinary circumstances 94, Incases of extraordinary circumstances beyond the contol of STADIO, STADIO reserves the right to close the institution temporarily orto make such aternatve teaching arrangements as are deemed feasible. 9.2. Whilst every effort willbe made to resume operating a soon as possible, no warranties are made in this regard and no refund in fees willbe made and this Registration Agreement will remain in full force and effect. 10. Additional terms 10.1. The Student confirms that he/she has access to a computer and the internet for the purposes of his/her studies. 10.2, The Student gives permission that details of their academic performance, ineluding but not limited to asessment results, a5 well as information on conduct may be shared by STADIO with the Co-princpsl debtor(s), a indicated in Part B ofthis Registration Agreement. 103. Norelaation, variation or indulgence granted by STADIO to the other signatories hereto in respect ofthis Registration ‘Agreement shall constitute a waiver of any rights vesting in STADI and no reliance may be placed by the Student or other signatory hereto or any statement or representation nat contained herein. 10.4. _Allthe provisions ofthis Registration Agreement shall be severable, nd no provision shall be affected by the invalidity of any other provision ofthis Registration Agreement. 10.5. This agreement shall apply together wth any other agreement that you enter into with STADIO. Inthe event of a conflict, the agreement entered into last wil apply. 10.6. STADIO confirms that ll ofcal communication will tke place through the Students allocated STADIO student number vis its platforms, The student consents to the student's e-mail adress serving as domicum citand et executandi forthe purpose of serving legal documents, including statements of account. The statement of account aso serves and constitutes a demand for payment.