JUST THINK,,,®

JOHAN ENGELBRECHT GOLF SCHOOL INTERNATIONAL

Head office- No 4A Proot st, Monte Vista, Northern Suburbs, Cape Town

Tel/ Fax: 021-558 7651   Johan Cell 07222 4 0686 / Verlisha 0722 731 403

Email: info@sajga.co.za......www.sajga.co.za

“School for future golf professionals”

APPLICATION FORM                         DATE: ………/………/……….…   

 Application for Northern Suburb Branch or West Coast Suburb Branch (please refer to brochure for time table and costs)

PARTICIPANT NAME: ………………………………….…………………………………………………………

Cell ……………………………………………Face book ……....……….……………… ……………..Age……….

ADDRESS: ……………………………………………………………………………………...….…………………

LANGUAGE: ……………………… Date of birth ……………………... SCHOOL………………………………..

STANDARD (grade)……..……………………..PART TIME ACTIVITIES: ……………...…………………….…

DOCTORS NAME: ……………………………………..……….TEL: ……………………………………………...

MEDICAL REPORT…....……………………………………..………………………………………………………

COST p.a. Payable on or before first day of coaching / or submit four post dated cheques dated: 30 Jan, 28 Feb, 30 March, and 30 April.

SIGNATURE of legal guardian

                                                   ……………………………………………………………………...

PARENTS DETAILS:

FARTHER’S NAME: ……………………..Occupation………………….……...…Cell Phone……….………….

MOTHER’S NAME………………………Occupation………………….…………Cell Phone………..…...…….

ADDRESS: ………………………………………………………………….……..Code………………………...

P O BOX: ………………………………….……………………………………….Code………………………...

TEL  WORK :………………………………….Home……………………………..…Fax ……………………….

E-MAIL: ………………………………………………………………….Website………….……………………..

RELATIVE NAME::………………………………………………………………….…………..

Cell:…………………………………….…Tel:………………………....

DIRECT BANK DEPOSIT or TRANSFERS

NAME:                                J. Engelbrecht

BANK:                                 Nedbank

CODE:                                 118602

ACCOUNT NO:                  1186005459