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Personal Information

Full Name *

Surname *

ID Number *

Contact Number

Email Address *

Student Number *

Residential Address

City *

Town *

Suburb *

Street Number *

Academic Information

Faculty

Course

Year of Study

Campus *

Next of Kin Information

Next of Kin Name *

Next of Kin Surname *

Next of Kin Contact *

Next of Kin Relationship

Next of Kin Email

Medical Emergencies

Any Disability / Special Needs (Specify Condition)

Accommodation Details

Institution Type *

Date of Registration *

Type of Student *

Room Type

Duration

Funding Type

NSFAS Reference Number *

Document Uploads

ID Copy *

Proof of Registration *

Proof of NSFAS Status *

Proof of Address

tAKE 3D /Profile Picture *

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Your username will be your assigned residence number

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