The deadline for 2013 Registrations is Tuesday 28 February 2012.
No application will be processed without proof of payment of deposit.

Numerical Information: Please insert dashes (-) not spaces between digits e.g. Country Code (254) + Area Code(2) + (679694) Telephone Number should read 254-2-679694

Registration Form pdf

* Required fields
Applicant Details
Surname:	*			Given (First) Names:	*
				Preferred Name:
Proposed Date of Entry:	Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 2034 2035 2036 2037 2038 2039 2040 2041 2042			Into Grade:	8/MHS E Block 9/MHS D Block 10/MHS C Block 11/MHS B Block 12/MHS A Block
Date of Birth:	1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 2012 2011 2010 2009 2008 2007 2006 2005 2004 2003 2002 2001 2000 1999 1998 1997 1996 1995 1994 1993 1992 1991 1990 1989 1988 1987 1986 1985 1984 1983 1982			Present School:
Country of Birth:				Home Language:
ID/Passport No.	*			Religious Denomination:
Please indicate how you heard about Michaelhouse:
Please choose... Recommended by a friend Attendance at a promotional event Family connection Other
If you chose Family Connection above, please complete the following:
Relationship: Father Grandfather Uncle Brother First Name & Surname: Year Left Michaelhouse:
Relationship: Father Grandfather Uncle Brother First Name & Surname: Year Left Michaelhouse:
Parent/Guardian Details
Father				Mother
Surname:				Surname:
Title:				Title:
First Name:				First Name:
ID/Passport No.				ID/Passport No.
Marital Status:	Please choose... Single Married Divorced Widowed			Marital Status:	Please choose... Single Married Divorced Widowed
Home Address:				Home Address:
Postal Address:				Postal Address:
Post Code:				Post Code:
Home Tel. No.				Home Tel. No.
Work Tel. No.				Work Tel. No.
Fax No.				Fax No.
Cellphone No.				Cellphone No.
Email Address:				Email Address:
Company Name:				Company Name:
Occupation:				Occupation:
Position:				Position:
Upon submission of this form and payment of the required Registration Fee, please note that: Michaelhouse reserves the right to conduct any credit bureau searches it deems necessary on any signatory hereto, and to satisfy itself that the parents can afford the fees and extras charged by Michaelhouse.

This application will be processed on receipt of the R750 registration fee made payable to "Michaelhouse".

Please e-mail a copy of the internet banking receipt to us or fax a copy of the deposit +27 (0) 33 234 1120

Banking Details:
Michaelhouse
Standard Bank
Pietermaritzburg Branch
Branch Code: 05752500
Account: 052211002

BLOCK This is the year of study that a pupil is in. "A Block" boys would be Standard 10, Grade 12, Year 12 or Matric, and "E Block" boys would be Standard 6, Grade 8 or Year 8. A Blockers are usually 17 or 18 when they finish at the end of the year in December. E Blockers are usually 13 or 14 when they enter Michaelhouse.