PROGRAMME APPLICATION FORM

admission for a new qualification

STUDENT NUMBER:

GENERAL INFORMATION AND INSTRUCTIONS

1. Please complete this form in full, in block letters

2. Remember to Initial each page and to sign, in full, on page 11
3. Certified copies of the following documents must accompany this form:
• ID Document
• Matric certificate
• Marriage certificate, where surname on Academic records differ to ID/Passport
• Proof of payment – refer to the fee schedule on the website www.stadio.ac.za
• Tertiary qualification (if applicable)
4. Acceptance for all programmes will be subject to academic selection

PERSONAL DETAILS

FIRST NAME:

SURNAME:

ID NUMBER:

CELLPHONE NUMBER:

HOME ADDRESS:

EMAIL ADDRESS:

NATIONALITY:

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

ACADEMIC HISTORY Tertiary Education

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

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STADIO (Pty) Limited, is a registered private higher education institution with the Department of Higher Education & Training under the Higher Education Act, 1997, with registration certificate number 2008/HE007/004

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INTERNATIONAL STUDENT DETAILS

PASSPORT NUMBER:

EXPIRY DATE:

COUNTRY OF RESIDENCE:

PERMIT TYPE: STUDY VISA PERMANENT RESIDENCE PERMIT OTHER / NA

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 6. Former difficulty, none now

SEEING 1 2 3 4 5 6

HEARING 1 2 3 4 5 6

COMMUNICATION (SPEECH) 1 2 3 4 5 6

PHYSICAL 1 2 3 4 5 6

EMOTIONAL 1 2 3 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 (DHET)

SOCIO ECONOMIC STATUS: EMPLOYED UNEMPLOYED, SEEKING WORK PENSIONER/RETIRED

STUDENT/SCHOLAR UNABLE TO WORK (DISABLED)

HOME LANGUAGE: AFRIKAANS ENGLISH ISINDEBELE ISIXHOSA

ISIZULU SEPEDI SISWATI XITSONGA

SETSWANA TSHIVENDA OTHER, PLEASE SPECIFY

GENDER: MALE FEMALE DO NOT WISH TO DISCLOSE

RACE: AFRICAN COLOURED INDIAN/ASIAN WHITE OTHER

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STADIO (Pty) Limited, is a registered private higher education institution with the Department of Higher Education & Training under the Higher Education Act, 1997, with registration certificate number 2008/HE007/004

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NEW PROGRAMME DETAILS What would you like to study?

QUALIFICATION TYPE: UNDERGRADUATE STUDIES POSTGRADUATE STUDIES

PROGRAMME NAME:

SPECIALISING IN:

CREDIT ACCUMULATION AND TRANSFER (CAT)

WILL YOU BE APPLYING FOR MODULE CREDITS: YES NO

DHET ACKNOWLEDGEMENT

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

I am fully aware that the programme I have enrolled for and that this programme is approved by the Department of Higher Education and
Training to STADIO (Pty) Ltd, as indicated on the registration certificate dated 6 October 2020.

I,

(Student Number) am fully aware that the programme that I have enrolled on, that is the programme name:

with SAQA ID * is registered with the Department of Higher Education and Training to STADIO,

as indicated on the registration certificate.

Student Signature: Date:

* Refer to your Information Pack for your specific programme’s SAQA ID Number - www.stadio.ac.za

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STADIO (Pty) Limited, is a registered private higher education institution with the Department of Higher Education & Training under the Higher Education Act, 1997, with registration certificate number 2008/HE007/004

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TERMS & CONDITIONS OF REGISTRATION (PART A)

Part A to be completed by the Student (Principle Debtor) Consent by the Parent/Legal guardian of a minor Student must be provided.

Registration Agreement entered into between STADIO (Pty) Limited, a registered private higher education institution with the Department of
Higher Education and Training under the Higher Education Act, 1997, with registration certificate number 2008/HE007/004
(hereinafter STADIO) and the Student.

GENERAL
1. Binding Registration Agreement
The applicant acknowledges and agrees that upon signature of the Registration Form (the “Registration Agreement”) a binding
contract comes into existence between the applicant and STADIO, in terms of which the applicant becomes a student of
STADIO.
1.1 The Registration Agreement remains in full force and effect for the duration of the academic year (being a calendar year) unless
specifically terminated by either party in terms of the STADIO rules.
1.2 Students are required to register for all modules for the full academic year during the first registration cycle of the year, the
period of which will be annually determined by STADIO. Registration includes modules for the first and second semesters, and
all year modules. There will be no registration period for contact learning (or the PGCE, Advanced Diploma TVET, and B.Ed
Honours) prior to the start of the second semester.
1.3 Prior to the commencement of the second semester registered students may, however, be permitted to add or cancel modules in
accordance with the STADIO rules.
1.4 It is the student’s responsibility to read and understand the terms and conditions of the Registration Agreement.
1.5 Upon signature of the Registration Agreement, the student confirms that she/he possesses the necessary understanding of the
terms and conditions of the Agreement and willingly and without duress accepts all the provisions.

2. Programme and modules

2.1. 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
STADIO website.
2.2. STADIO 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.
2.3. STADIO shall have the right to alter the location of delivery of the programme, with reasonable notice.
2.4. STADIO shall have the right in its sole discretion, to postpone or cancel any programme or course initially advertised and offered,
based on insufficient demand.
2.5. The student is entitled to transfer his/her studies from one STADIO programme to another, at the same campus, and in the same
academic year subject to meeting the admission criteria of the other programme, and subject to following the administrative
process prescribed by STADIO.
2.6. The student will only be awarded the qualification on the successful completion of all the academic requirements of the
programme enrolled for as stipulated by STADIO, after which the student’s registration shall terminate unless it is terminated
earlier by the student’s written withdrawal from the programme.

3. Cancellation of studies
3.1. The Student reserves the right to cancel this Registration Agreement.
3.2. In case of a cancellation, a reasonable cancellation fee (outlined in clause 18 below) will become payable.
3.3. Cancellation of registration must be done in writing and in accordance with the administrative process prescribed.

4. Information
4.1. The Student warrants that all information provided to STADIO is true and correct in every respect and that any false information
provided may lead to the termination of the Student’s registration at any time and that STADIO may inform others, including but
not limited to, Government agencies and regulatory or professional bodies, of this false information.
4.2. 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 of any fees paid and will be liable to settle the balance of outstanding fees.
4.3. The Student guarantees that all supporting documents provided are accurate copies of the original documents and if proved
otherwise STADIO reserves the right to cancel the Registration Agreement by written notification without redress.

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5. Transfer of studies
5.1. The Student is entitled under certain circumstances to transfer his/her tuition to another STADIO campus where the specific
programme is on offer, or to another mode of delivery, if available.
5.2. The prescribed administrative processes must be followed, and an administration fee may become payable.
5.3. The consent to transfer will be at the sole discretion of STADIO.

6. Transfer of credits
6.1. An applicant/student may apply for transfer of credits obtained on the same NQF level from another accredited higher
education institution, or for the exemption of parts of the programme on the basis of recognition of prior learning (RPL).
Such applications need to be done on the prescribed Credit Accumulation and Transfer (CAT) or Recognition of Prior Learning
(RPL) forms, upon payment of the prescribed fee(s).
6.2. The student hereby acknowledges that they should await the outcome of such a CAT/RPL application before registering for the
module for which credits are sought.

7. Codes, rules and regulations

7.1. The Student hereby undertakes to familiarise him/herself with the codes, rules and regulations of STADIO 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;
7.1.1. Student Code of Conduct
7.1.2. Faculty/School/Programme rule books
7.1.3. Website Privacy and Security policy
7.2. STADIO 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.
7.3. STADIO 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 STADIO, as communicated in official documentation.
7.4. If the Student is expelled or dismissed from an institution or organisation other than STADIO which the Student is required
to attend or be a member of as part of the programme, STADIO shall be entitled to end this Registration Agreement immediately
by written notice to the Student.

8. Khulisa Student Share Scheme

8.1. On graduation you may be eligible to receive shares in STADIO Holdings Limited through the STADIO Khulisa Student Share
Scheme (“student share scheme”). It is noted that no student is entitled to receive shares through the student share scheme upon
graduation and the criteria for this award will be subject to the sole discretion of the STADIO Holdings Executive Committee,
whose decision will be communicated to the respective graduates upon graduation (“Eligible graduates”).
8.2. Should you meet the criteria to be an Eligible Graduate, you hereby consent to STADIO sharing your personal and special
personal information (including your name, ID number, student number, language, race. Address) with Investec and the JSE
Investor Services (JIS). This information is required by Investec and the JIS to facilitate the creation of a share portfolio for you
on the JIS Share Platform and to provide you with log-in details to access the Share Platform should you become a participant
of the STADIO Khulisa student share scheme. Any share awards through the STADIO Khulisa Student Share Scheme are subject
to the terms and conditions of the STADIO Khulisa Student Share scheme.

9. Intellectual property ownership

9.1. The Student hereby cedes and assigns to STADIO 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 STADIO, irrespective of
whether such work has been or may be accepted for examination, in accordance with national legislation and STADIO’s policy
related to intellectual property.

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10. Legal declaration of indemnity

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

11. Extraordinary circumstances

11.1. In cases of extraordinary circumstances beyond the control of STADIO, STADIO reserves the right to close the institution
temporarily or to make such alternative teaching arrangements as are deemed feasible.
11.2. 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.

12. Additional terms

12.1. The Student confirms that he/she has access to a computer and the internet for the purposes of his/her studies.
12.2. 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 STADIO with the Co-principal debtor(s), as indicated in Part B of this Registration
Agreement.
12.3. No relaxation, variation or indulgence granted by STADIO to the other signatories hereto in respect of this Registration
Agreement shall constitute a waiver of any rights vesting in STADIO in terms hereto, and no reliance may be placed by the
Student or other signatory hereto or any statement or representation not contained herein.
12.4. All the provisions of this Registration Agreement shall be severable, and no provision shall be affected by the invalidity of another
provision of this Registration Agreement.
12.5. This agreement shall apply together with any other agreement that you enter into with STADIO. In the event of a conflict, the
agreement entered into last will apply.
12.6. The Student 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.

13. Breach and termination

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

FEES AND FUNDING

14. Liability for fees and costs
14.1. The Student hereby binds him/herself to STADIO, jointly and severally with Co-principal Debtor(s) where applicable, for the
payment of all fees and charges that become due by them to STADIO as a result of registration in terms of this Registration
Agreement.
14.2. Fees, charges and payment terms are outlined in the STADIO Fee Schedule annexed hereto.
14.3. A certificate issued under the signature of a duly authorised employee, or representative of STADIO, that purports to certify the
amount due by the Student shall be accepted as prima facie proof of such indebtedness and shall have sufficient probative value
to enable STADIO to obtain summary judgement or provisional sentence against the Student in any competent court for the
amount stated in such certificate.
14.4. The Student shall not be entitled for any reason whatsoever to withhold or defer payment stipulated in this Registration
Agreement.

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14.5. Failure to pay any single instalment timeously shall result in the full balance due for the academic period becoming immediately
due and payable.
14.6. STADIO reserves the right to charge interest on late payments at a maximum rate of 2% per month on all overdue accounts.
14.7. STADIO reserves the right to cede the collection of fees to a finance house or other institution. In this regard, the term
“STADIO” shall include such cessionary/ies. In such a case, the payment terms of the finance house will apply.
14.8. 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 STADIO to their attorneys for the recovery of any
outstanding fees.
14.9 In the unfortunate event of the Student becoming incapacitated or otherwise unable to continue their studies with STADIO, or
the Student passing away, the Student, his/her estate, and/or Co-principal Debtor may become entitled, subject to the sole
discretion of STADIO, to a pro-rata refund of tuition fees already paid in the proportions paid by different parties.
14.9. 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.

15. In the event of a Student defaulting on payment of fees, STADIO reserves the right to:
15.1.1. withhold the Student’s assessment results;
15.1.2. withhold the qualification certificate and academic transcript of a graduating Student, and refuse the Student participation in the
STADIO graduation ceremony;
15.1.3. refuse to register a Student for any further modules or courses;
15.1.4. recover all outstanding amounts from the Student, as per this Registration Agreement.
15.1.5 In the event of a Student defaulting on payment of fees on a year module, STADIO reserves the right to cancel the Student’s
registration and exclude the Student from access to STADIO’s premises and systems during the academic year, unless the
Student has entered into a formal, approved payment arrangement with STADIO.

16. Registration fee

16.1. A non-refundable registration fee becomes payable per semester or per year, depending on the study mode selected. The
Student’s registration will not be processed until such time as the registration fee has been received.

17. Tuition Fees

17.1. Tuition fees include the following, for the academic period registered for:
17.1.1. Study material, excluding textbooks, unless otherwise specified;
17.1.2. Assessments and assessment facilities;
17.1.3. Access to the relevant and applicable physical and online campus facilities of STADIO;
17.1.4. Standard student support services related to the modules selected.
17.2. The following are expressly not covered by tuition fees and may be charged separately by STADIO:
17.2.1. Textbooks, unless otherwise specified;
17.2.2. Stationery, consumables and specialised equipment kits, where applicable;
17.2.3. Any levies;
17.2.4. Any fees related to excursions, such as transport, food, entrance fees, and the like;
17.2.5. Fees for examinations with external examination bodies, such as certification bodies, where applicable;
17.2.6. Student cards, campus parking and related fees;
17.2.7. Fees for supplementary examinations, special examinations, remarks of assessments, or similar.
17.3. In the case where the Student is enrolled on a contact learning programme, a deposit, which is an advance payment of tuition
fees, becomes payable. The deposit is refundable, subject to payment of the prescribed withdrawal fee, under circumstances
described in clause 18.

18.
Cancellation fees
18.1.
The deposit and balance of the tuition fees are refundable to contact learning Students (or the PGCE, Advanced Diploma TVET,
and B.Ed Honours, as follows:
18.1.1. 100% minus the prescribed withdrawal fee, if cancelling on or before fourteen (14) calendar days after the first day
of the STADIO academic year registered for; or
18.1.2. 0%, if cancelling later than fourteen (14) calendar days after the first day of the STADIO academic year
registered for.

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STADIO (Pty) Limited, is a registered private higher education institution with the Department of Higher Education & Training under the Higher Education Act, 1997, with registration certificate number 2008/HE007/004

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18.2. The balance of the tuition fees are refundable to a distance learning Student cancelling their first semester of registration as
follows:
18.3.1. 100%, if cancelling on or before fourteen (14) calendar days of registration, provided that no study materials have
been dispatched;
18.3.2. 50%, if cancelling on or before fourteen (14) calendar days of registration, if study materials have been dispatched.
18.3.3. 0%, if cancelling later than fourteen (14) calendar days of registration.
18.3. In the case of a Student registering late, after the closing date of registration, the deposit (if applicable) and balance of the tuition
fees (where applicable), are refundable to a Student cancelling their registration, as follows:
18.4.1. 100%, if cancelling on or before seven (7) calendar days after date of late registration, provided that no study
materials have been dispatched;
18.4.2. 50%, if cancelling on or before seven (7) calendar days after date of late registration if study materials have been
dispatched.
18.4.3. 0%, if cancelling later than seven (7) calendar days after date of late registration.

19. Student declaration and undertaking

19.1. To administer your application, it is necessary for STADIO to process some of your personal information, including but
not necessarily limited to: Identifying information, biometric information, contact information (including address), demographic
details, academic details regarding prior learning, 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. Should your
application be successful, and you are registered, STADIO will also process information on your academic progress, assessment of
learning and correspondence.
19.2. STADIO respects the right to privacy and will only process your personal information for the following purposes:
19.2.1. delivering academic services (including but not limited to: administering Student and prospective Student
admissions, enrolment, registration, education, engagement, and validation of qualifications);
19.2.2. providing information on additional academic service offerings;
19.2.3. fee payment or collection;
19.2.4. any additional purposes to which you consent; and
19.2.5. as otherwise required by law.
19.3. By accepting this privacy notice, you give consent that STADIO and its approved representatives may:
19.3.1. process your personal information for the purposes stated above as well as any other directly related purposes,
including cloud storage of your information outside the RSA;
19.3.2. 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;
19.3.3. share your personal information with qualification verification agencies, who in turn may enter your qualification
information into the National Learners’ Records Database;
19.3.4. share your personal information with third party service providers engaged by STADIO for the purposes listed
above;
19.3.5. contact you with information about additional academic service offerings with the option to opt out of further
similar correspondence;
19.3.6. process as confidential information any health information provided by you for the purpose of accommodating
disability or sick leave;
19.3.7. process your personal information as needed to meet security requirements, and the requirements of government,
professional bodies and other regulatory authorities; and
19.3.8. in the event of any reorganisation, merger, or acquisition of STADIO, your personal information may be transferred
as part of the transaction to the acquirer, whether inside or outside the RSA.
19.4. In addition - If successfully admitted as a Student of a corporate account:
19.4.1. You consent to STADIO receiving your personal information necessary for the application and registration process
from your employer.
19.5. All students – By accepting this privacy notice you also make the following declaration:
19.5.1. I hereby certify that I will provide information that is correct and complete. I understand that false or incomplete
information will invalidate this application.
19.5.2. Signature on acceptance of Registration Terms and Conditions denotes acceptance of the STADIO privacy policy
and declaration.

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STADIO (Pty) Limited, is a registered private higher education institution with the Department of Higher Education & Training under the Higher Education Act, 1997, with registration certificate number 2008/HE007/004

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AVAILABLE PAYMENT PLAN OPTIONS Indicate with an X

Full payment in advance (one single payment) If this option is selected, please provide your
PLAN A: BURSARY:
- refer to fee schedule for details. Bursary letter.
PLAN B: Monthly payments in advance, payable on the first STUDENT LOAN: If this option is selected, please provide
of the month - refer to fee schedule for details. confirmation of your approved Student Loan.

AVAILABLE PAYMENT METHOD OPTIONS Indicate with an X

DEBIT ORDER: please complete the Debit Order form attached. DIRECT EFT:

PAYMENT OF FEES Indicate with an X

I am a minor and my parent/legal guardian, and/or other party, will act as my co-principal debtor who will take responsibility for the
payment of all fees that become due under this Agreement. (Part B of this agreement must be completed).
I am a full-time student and my parent/legal guardian, and/or other party, will act as my co-principal debtor who will take responsibility
for the payment of all fees that become due under this Agreement. (Part B of this agreement must be completed).
I am employed and agree to be personally responsible and liable for any fees that become due under this Agreement. (proof of
employment or payslip must be attached). As the Principal Payer I declare the following:
Yes | No I have not applied for voluntary sequestration (insolvency) nor Yes | No I have not had an application for compulsory sequestration (insolvency)
do I have any requirement or intention of completing such an brought against me nor do I have any reasonable expectation that such an
application within the current academic year. application will be brought against me within the current academic year.
Yes | No I am not an unrehabilitated insolvent. Yes | No I am not currently under debt review.

ACCEPTANCE OF REGISTRATION AGREEMENT

By accepting these Registration Terms and Conditions, I am confirming 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 STADIO 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 ON THIS DAY OF 20 AT

I, the Student hereby consent to entering into

this Registration Agreement, as outlined above, with STADIO.

SIGNED:

IN THE EVENT OF THE STUDENT BEING A MINOR

NAME OF PARENT /
LEGAL GUARDIAN:
IDENTITY NUMBER OF
PARENT / LEGAL GUARDIAN:
DOMICILIUM:

E-MAIL ADDRESS:

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 STADIO.

SIGNED: INITIA
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STADIO (Pty) Limited, is a registered private higher education institution with the Department of Higher Education & Training under the Higher Education Act, 1997, with registration certificate number 2008/HE007/004

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TERMS & CONDITIONS OF REGISTRATION (PART B) - CO-PRINCIPAL DEBTOR (IF APPLICABLE)

Part B to be completed by the Co-Principal Debtor i.e. Parent/Legal Guardian of a minor Student, and/or by any other party (other than the student)
who takes responsibility for the payment of the Student’s fees in terms of the Registration Agreement.

Student Full Name:

Student Number:

1. General
1.1. The Co-principal Debtor hereby bind(s) themselves to STADIO, 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 STADIO in terms of this Registration
Agreement.
1.2. The Co-principal Debtor agrees that STADIO 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.
1.3. This Registration Agreement can only be cancelled or withdrawn with STADIO’s written permission.
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. Credit check
2.1. By completing and submitting the Registration Agreement, the Co-principal Debtor authorises STADIO to access any
information available to assess his/her application, and also gives STADIO permission to conduct a credit check with any National
Credit Regulator (NCR) registered credit bureau or third party.

3. Payer declaration and undertaking

3.1. To administer the application, it is necessary for STADIO 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.
3.2. STADIO respects the right to privacy and will only process the Co-principal Debtor’s personal information for the following
purposes:
3.2.1. fee payment or collection;
3.2.2. any additional purposes to which the Co-principal Debtor consents; and
3.2.3. as otherwise required by law.
3.3. By accepting this privacy notice, the Co-principal Debtor consents that STADIO and its approved representatives may:
3.3.1. 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 the RSA;
3.3.2. in the event of any reorganisation, merger, or acquisition of STADIO, the Co-principal Debtor’s personal
information may be transferred as part of the transaction to the acquirer, whether inside or outside the RSA.

PAYER DECLARATION As the Co-Principal Payer I declare the following

Yes | No I have not applied for voluntary sequestration (insolvency) nor do I have any requirement or intention of completing such an
application within the current academic year.
Yes | No I have not had an application for compulsory sequestration (insolvency) brought against me nor do I have any reasonable
expectation that such an application will be brought against me within the current academic year.
Yes | No I am not an unrehabilitated insolvent.
Yes | No I am not currently under debt review.

INITIA
INITIALL
INITIA L

STADIO (Pty) Limited, is a registered private higher education institution with the Department of Higher Education & Training under the Higher Education Act, 1997, with registration certificate number 2008/HE007/004

STADIO Programme Application Form | v2023-01 | STADIO Office 101 The Village Square, Cnrs Oxford & Queen Street, Durbanville, Cape Town, South Africa, 7550 Page 10 of 11
PROGRAMME APPLICATION FORM
admission for a new qualification

CO-PRINCIPAL DEBTOR PERSONAL INFORMATION

To be completed by the Parent/Legal Guardian of a minor Student, and/or by any other party (other than the student) who takes responsibility for
the payment of the Student’s fees in terms of the Registration Agreement.

Full Name / Company:

(Sponsor) Name:

ID / Company Reg No:

Home Address:

Email Address:

Cell Phone Number:

Alternate Phone No:

Race:

Gender:

Nationality:

Employment Status:

Employer Name:

Employment Sector:

Employer Address:

Martital Status:

I, hereby bind myself as surety and

co- principal debtor in favour of STADIO for all of the obligations of the Student to STADIO pursuant to the entering into of the
aforementioned Registration Agreement and declare that the indebtedness of the Student to STADIO 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 STADIO in respect of the Registration Agreement, and in respect of any breach by the Student of any terms of that Registration
Agreement.

SIGNED ON THIS DAY OF 20

AT

SIGNED:

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

NAME:

SIGNED:
INITIA
INITIALL
INITIA L

STADIO (Pty) Limited, is a registered private higher education institution with the Department of Higher Education & Training under the Higher Education Act, 1997, with registration certificate number 2008/HE007/004

STADIO Programme Application Form | v2023-01 | STADIO Office 101 The Village Square, Cnrs Oxford & Queen Street, Durbanville, Cape Town, South Africa, 7550 Page 11 of 11