Annexure A1
Application for exemption of learner from school attendance
(Application in terms of directions 6(1)(a), 6(1)(b), 6(1)(c), 6(2)(a), 6(2)(b), 9(6)(b)(i) and 9(6)(b)(ii))
(To be completed by the parent/caregiver/designated family member)I, __________________________________________________ (Name and surname), the parent, caregiver or a designated family member (delete whichever is not applicable) of_______________________________________________(Name of learner) who is in Grade ________at _____________________________________________________________(Name of school), hereby apply to the Head of Department to exempt the learner from compulsory school attendance, in terms of section 4 of the South African Schools Act, 1996 (Act No. 84 of 1996), for the period of the national state of disaster.I do so, and take full responsibility, to oversee the learning of the learner at home as indicated in the signed agreement (Annexure A2). The reasons for my application for exemption are as follows:
Reason |
Further Details |
Underlying health condition and/or comorbidity of the learner or a close family member |
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General concern over the risk of transmission of COVID-19 |
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In respect of a learner with a medical condition, as contemplated in direction 6(1)(a): Evidence of medical condition of learner is attached/not attached (delete whichever is not applicable).In respect of a learner with special needs, as contemplated in direction 9(6), the parent/caregiver/designated family member of the learner must, in terms of direction 9(6)(b)(ii), specify the support needs of the learner in respect of teaching and learning material, assistive devices or therapeutic services, as follows:
Part |
Needs of Learner |
Further Details |
A |
Teaching and Learning Support Material |
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B |
Assistive Device |
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C |
Therapeutic Service |
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Signed at ____________________________________________________________________ on this __________ day of _________________ 2021.___________________________________ __________________________________Parent/caregiver/designated family member Full name and surname of parent/ caregiver/designated family memberContact number: _____________________
Annexure A2
Parent acceptance form: To adhere to conditions for exemption from compulsory school attendance
(Application in terms of directions 6(2)(a), 6(2)(b), 9(6)(b)(i) and 9(6)(b)(ii))
(To be completed by the parent/caregiver/designated family member)I_______________________________________________________ (Name and surname), the parent, caregiver or a designated family member (delete whichever is not applicable) of ________________________________ (Name of learner) who is in Grade ___________________ at ______________________________________________ (Name of school), hereby accept the following conditions for the exemption of the learner from compulsory school attendance for the duration of national state of disaster:(1)I accept and agree that I will take responsibility—(a)to oversee the daily learning of the learner at home, including the daily work and assessments;(b)to ensure that the learner is informed of the work that must be learned and the work that must be completed on a daily basis; and(c)to ensure that all work and assignments are collected or accessed and returned to school, in accordance with the arrangements made with the school.(2)I accept and agree that, if the conditions in this Annexure are not met, the exemption from compulsory school attendance may be withdrawn.(3)I accept and understand that, if I am unable to accept these conditions and the associated responsibilities, then the learner should continue to attend school.Signed at ____________________________________ on this ____________ day of _____________________ 2021.__________________________________________Parent/Caregiver/Designated family member__________________________________________Full NameContact number: _____________________
Annexure B
Notification of opening of hostel(s)
(Notification in terms of directions 10(1) and 10(2))
(To be completed by the principal, chairperson of the school governing body or board, or their delegated official)I, __________________________________ (Name and surname), the principal/ chairperson of the school governing body or board / delegated official (delete whichever is not applicable), of _________________________________ (Name of school), hereby notify the Head of Department of my/our decision to open the hostel(s), as contemplated in direction 10(1).School and hostel particulars
Province: |
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District: |
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Circuit: |
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Name of school and hostel(s): |
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EMIS Number: |
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Principal’s name andsurname:
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Tel / Cell No: |
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E-mail Address: |
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Highest Grade: |
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Lowest Grade: |
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Number of learners: |
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Signed at ___________________________________ on this _______ day of ___________________________ 2021._______________________________________________PrincipalDate:_______________________________________________Chairperson of the governing body/ school boardDate:Official Stamp
Annexure B1
Declaration confirming compliance of public school
(Declaration in terms of direction 10(2)(a))
(To be completed by the principal, chairperson of the governing body, or their delegated official, in respect of public schools, and attached to Annexure B)I, ________________________________________________________ (Name and surname), the principal / chairperson of the governing body or school board / their delegated official (delete whichever is not applicable), of ____________________________________________________________ (Name of school), hereby declare that the hostel(s) has/have complied with the health, safety and social distancing measures for COVID-19, set out in the DBE Standard Operating Procedures and the DBE Guidelines and has/have all the COVID-19 essentials in place.I further acknowledge that it is the responsibility of the school governing body, the principal and/or the school board to take all reasonable steps to comply with the health, safety and social distancing measures for COVID-19, set out in the DBE Standard Operating Procedures and the DBE Guidelines.Signed at ______________________________________________ on this ____________ day of_____________________ 2021._______________________________________________________PrincipalDate:________________________________________________________Chairperson of the governing body/ school boardDate:Official stamp
Annexure B2
Declaration confirming compliance of independent school hostel(s)
(Declaration in terms of direction 10(2)(b))
(To be completed by the principal, chairperson of the governing body, or their delegated official in respect of independent schools, and attached to Annexure B)I, ____________________________________________________________________________ (Name and surname), the principal/chairperson of the school board/their delegated official (delete whichever is not applicable), of _____________________________________________________________ (Name of school), hereby declare that the hostel(s) has/have complied with the health, safety and social distancing measures for COVID-19, set out in the DBE Standard Operating Procedures and the DBE Guidelines.I further acknowledge that it is the responsibility of the principal and/or the school board to take all reasonable steps to comply with the health, safety and social distancing measures for COVID-19, set out in the DBE Standard Operating Procedures and the DBE Guidelines.I further accept that any civil liability that may arise from the school’s decision to reopen its hostel(s) and the manner in which the hostel(s) operate/s following such reopening, shall fall exclusively on the school and that the relevant Department of Basic Education and Provincial Departments of Education shall bear no liability in this regard.Signed at _________________________________________ on this _________ day of _________ 2021.__________________________________________________________________________PrincipalDate:__________________________________________________________________________Chairperson of the governing body/ school boardDate:Official stamp