…………………/Page 4 Section C: Learner Details Personal Details Surname (Last Name) Previous Surname First Name Middle Name Title (Mr/Mrs, etc.) ID No. Learners must please submit a certified copy of their ID Alternative ID Type (please tick box) 521 – SAQA Member ID 527 – Passport 529 – Driver’s Licence 531 – Temporary ID 533 – None 535 – Unknown 537 – Student Number 538 – Work Permit 539 – Employee No. 540 – Birth Cert. 541 – HSRC Register 561 – ETQA Record Alternative ID No. Date Birth Nationality (please tick box) Unspecified – U South Africa – SA Namibia – NAM Botswana – BOT Angola – ANG Mozambique – MOZ Lesotho – LES Swaziland – SWA Zambia – ZAM Mauritius – MAU Tanzania – TAN Seychelles – SEY Europe – EUR Central and South America – SOU Australia and New Zealand – AUS Rest of Africa – ROA Citizen Resident Status (please tick box) Unknown – U South Africa – SA Other – O Dual (SA plus Other) – D Gender (please tick box) Male – M Female – F Equity (please tick box) BA – Black African BC – Black Coloured BI – Black Indian U – Unknown WH – White Home Language (please tick box) Afr – Afrikaans Eng – English Ita – Italian Rus – Russian Spa – Spanish Xho – isiXhosa Ara – Arabic Fre – French Mas – Masai Sep – sePedi Swa – siSwati Xit – xiTshonga Bul – Bulgarian Ger – German Nde – isiNdebele Ses – seSotho Swe – Swedish Zul – isiZulu Chi – Chinese Gre – Greek Oth – Other Set – seTswana Tsh – tshiVenda Dan – Danish Heb – Hebrew Pol – Polish Shl – Swahili U – Unknown Dut – Dutch Hin – Hindi Por – Portuguese Sho – Shona Urd – Urdu Disability Status (please tick box) N – None 02 – Hearing 04 – Physical 06 – Emotional 08 – Unspecified 01 – Sight 03 – Communication 05 – Intellectual 07 – Multiple U – Status Unknown Socio-Economic Status (please tick box) U – Unspecified 02 – Unemployed 06 – Student 08 – Unemployed - Disabled 01 – Employed 04 – Homemaker 07 – Retired …………………/Page 5
…………………/Page 4 Section C: Learner Details Personal Details Surname (Last Name) Previous Surname First Name Middle Name Title (Mr/Mrs, etc.) ID No. Learners must please submit a certified copy of their ID Alternative ID Type (please tick box) 521 – SAQA Member ID 527 – Passport 529 – Driver’s Licence 531 – Temporary ID 533 – None 535 – Unknown 537 – Student Number 538 – Work Permit 539 – Employee No. 540 – Birth Cert. 541 – HSRC Register 561 – ETQA Record Alternative ID No. Date Birth Nationality (please tick box) Unspecified – U South Africa – SA Namibia – NAM Botswana – BOT Angola – ANG Mozambique – MOZ Lesotho – LES Swaziland – SWA Zambia – ZAM Mauritius – MAU Tanzania – TAN Seychelles – SEY Europe – EUR Central and South America – SOU Australia and New Zealand – AUS Rest of Africa – ROA Citizen Resident Status (please tick box) Unknown – U South Africa – SA Other – O Dual (SA plus Other) – D Gender (please tick box) Male – M Female – F Equity (please tick box) BA – Black African BC – Black Coloured BI – Black Indian U – Unknown WH – White Home Language (please tick box) Afr – Afrikaans Ara – Arabic Bul – Bulgarian Chi – Chinese Dan – Danish Dut – Dutch Eng – English Fre – French Ger – German Gre – Greek Heb – Hebrew Hin – Hindi Ita – Italian Mas – Masai Nde – isiNdebele Oth – Other Pol – Polish Por – Portuguese Rus – Russian Sep – sePedi Ses – seSotho Set – seTswana Shl – Swahili Sho – Shona Spa – Spanish Swa – siSwati Swe – Swedish Tsh – tshiVenda U – Unknown Urd – Urdu Xho – isiXhosa Xit – xiTshonga Zul – isiZulu Disability Status (please tick box) N – None 01 – Sight 02 – Hearing 03 – Communication 04 – Physical 05 – Intellectual 06 – Emotional 07 – Multiple 08 – Unspecified U – Status Unknown Socio-Economic Status (please tick box) U – Unspecified 01 – Employed 02 – Unemployed 04 – Homemaker 06 – Student 07 – Retired 08 – Unemployed - Disabled …………………/Page 5
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