Active Home Education Institute

Before You Begin

VLC Agreement form completed

Then complete the Virtual Learning Centre Registration form.

Student Information

Starting Date*

Pro-rata invoicing applies

Current Grade*

First Name*

Last Name*

SA ID Number*

Gender*

MaleFemale

Student Email Address*

Personal Gmail required — not parent's

Student Cell Number*

Mother's Information

First Name*

Last Name*

ID Number*

Cell Number*

Email Address*

Father's Information

First Name*

Last Name*

ID Number*

Cell Number*

Email Address*

Additional Information

Home Address*

Include town, postal code, province, and country

Marital Status*

Guardian Name & Email*

Complete if student is not with biological parents, otherwise enter n/a

Student Location During School Hours (8am – 2pm)*

Where will the student be during school hours?

Policy Acknowledgements

I understand that payment is due upfront and that student login access will be suspended if payment is not received by the 5th of each month.I confirm that my student has access to: 1 dedicated PC or laptop per student, a proper internet connection, and a working camera and microphone.I understand that attendance hours are 8am – 2pm daily and that attendance is compulsory.I accept responsibility for ensuring my student completes daily homework as assigned by teachers.I accept the use of the electronic planning chart as part of the VLC programme.

Additional Comments

Comments

Any learning differences, special requirements, or important notes (optional)

Your Full Name*

Registration Form

Before You Begin

Student Information

Mother's Information

Father's Information

Additional Information

Policy Acknowledgements

Additional Comments