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FAMILY MEMBER (closest relationship in SA not living with you)

EMPLOYER – Main income earner

EMPLOYER – Second income earner (If Applicable)


Monthly Income

Monthly Expenses


Please contact Jackie to receive information about our school fees structure on or 021 553 1530.


Account name: Melkbosstrand Private School
Bank :Standard Bank Branch : 022209 (Bayside)
Current account no : 271210346
Reference  : Account no or Learner’s Surname and Name 


I/We confirm that this agreement is binding despite changes to my/our marital status, or any terms of settlement, which may arise from a divorce agreement.I/We, further agree that in the event of me /our failing to pay school fees by the due date, I/we will be liable for all attorney and own-client charges incurred by MELKBOSSTRAND PRIVATE SCHOOL, to recover such fees, which costs shall include collection, commission and agents tracing fees.Enrolment fees payable on application are not be refundable.

Written notice of 3 months is required upon leaving the school. Shorter notice would require the payment of 3 months school fees in lieu of notice.

DEBIT ORDER (If not paying Annual in Advance)

Debit Order Authorisation

I/We hereby authorise Melkbosstrand Private School (The School) to draw against my/our account with the below-mentioned bank or any bank or branch to which I/we may transfer my/our account. This instruction shall remain in force and effect while my child remains a learner of Melkbosstrand Private School. All such withdrawals from my/our bank account by you shall be treated as though they had been signed by me/us personally.

I/We understand that the withdrawals hereby authorised will be processed by Electronic Funds Transfer Service (EFTS) provided by Multi Data (Pty) Ltd and that details of each withdrawal will appear on my bank statement. I/we agree to pay any bank charges incurred by this debit order instruction.

I/We further authorise “The School” that in the event that a debit order is returned by the bank for insufficient funds or for whatever any other reason and where no alternative payment arrangements for the advance payment of monthly school fees has been made within 7 days that the debit order amount may be increased in the month following to recover any outstanding school fees.
This authorisation may be cancelled by me/us by giving you thirty days’ notice in writing, but I/we understand that I/we shall not be entitled to any refunds of amounts which you have withdrawn while this authority was in force if such payments were legally owing to you.

Receipt of this instruction shall be regarded as receipt thereof by our bank.





1.1 The person(s) responsible for the account (hereafter “the responsible person”) as set out in the Application Form above (“the Application Form”) herewith assumes liability for the account, alternatively binds himself as co-debtor and surety for payment of all school fees to Melkbosstrand Private School (“the school”). 1.2 The guardian, as described in the Application Form, binds himself as surety and co-debtor for the payment of all school fees by the responsible person or any other payments that may arise from this agreement.

2.1 It is recorded that school fees are determined at the beginning of the year and responsible persons are informed of the result in writing. After the yearly determination of fees all responsible persons are invoiced for the school fees. 2.2 The responsible person shall immediately inform the school if he has not received an invoice at the start of the academic year. 2.3 School fees are payable yearly in advance or monthly for 12 months by means of a debit order, by the responsible person in the Application Form. 2.4 Payments are to be made in advance or before the third day of every month in the event where the entire fee is not paid up front.

3.1 In the event where the undersigned surety, responsible person or guardian commits a breach of contract of any of the terms of this agreement, the school may in its sole discretion: 3.1.1 Refuse the student entry to the school’s premises and withhold all assessment reports until the breach has been remedied; or 3.1.2 Claim damages from the responsible person and / or the sureties and guardian 3.1.3 Take whatever legal steps that may be necessary.

Melkbosstrand Private School (the school/MPS), the directors, employees, contractors or agents jointly or separately, accepts no responsibility for any injury, loss or damage from whatever nature occurring on the terrain of MPS or the participation in any activity of and/or at MPS, irrespective whether on the terrain of MPS or elsewhere, or the transport to and from any such activity. The indemnity is in addition to any specific indemnity that may be requested and is applicable irrespective where such indemnity has been granted or not. The indemnity does not limit the responsibility for damages resulting from gross negligence.

This Agreement constitutes the whole Agreement between the parties relating to the subject matter hereof. No amendment or consensual cancellation of this Agreement or any provision or term thereof or of any Agreement, bill of exchange or other document issued or executed pursuant to or in terms of this Agreement and no settlement of any disputes arising under this Agreement and no extension of time, waiver or relaxation or suspension of any of the provisions or terms of this Agreement or of any Agreement, bill of exchange or other document issued pursuant to or in terms of this Agreement shall be binding unless recorded in a written document signed by the parties. Any such extension, waiver or relaxation or suspension which is so given or made shall be strictly construed as relating strictly to the matter in respect whereof it was made or given

This agreement is subject to South African law.

The undersigned, responsible person, surety and/or guardian hereby consents that the school may perform all necessary credit vetting procedures including the disclosure and exchange of personal and financial information with and to a credit bureau or financial institution in accordance with the National Credit Act 34 of 2005.

8. DOMICILIUM The parties choose as their domicilia citandi et executandi the addresses set out in the Application Form.

9. LEGAL FEES In the event where the school takes legal action against the responsible person he will be liable for all legal fees on an attorney client scale, collection costs and commission, interest and tracing fees.


  • 10.1 The responsible person undertakes to give 3 months written notice of termination of the enrolment of a student.
  • 10.2 The School shall be entitled to terminate the enrolment of any student under the following circumstances: 10.2.1 Summarily, and with immediate effect, if the student is guilty of an offence which, in the sole opinion of the School renders his continued enrolment at the School impossible, in which event the responsible person, after deduction of all amounts otherwise owing to the School, will be refunded a pro-rata proportion of any fees already paid in advance in respect of such student, but not be entitled to the refund of the enrolment fee.
  • 10.2.2 If the responsible person fails to meet his/her financial obligations towards the school.

G) Melkbosstrand Private School: Summary of Code of Conduct

In the school context, administrators, educators, parents and students all have responsibilities. To sustain a positive, orderly and disciplined learning environment, it is important that these parties to the education relationship acknowledge their responsibilities.
Acceptance of your application is subject to that you, and your child, have acquainted yourselves with, and signed, the Procedure and Code: Learner Discipline document.

While parents must expect the school and its educators to provide the best education possible with the resources available to the school, parents must also accept responsibility to help the school achieve this goal.
Parents enrol their children at the school, subject to their acceptance of all the school rules and other conditions of admission. Parents also have the responsibility to:

  • Support the Vision, Mission and Values of the school.
  • Actively support the efforts of the school and its educators to teach their children.
  • Involve themselves to the fullest possible extent in school activities.
  • Make positive suggestions and contributions to improve the school’s education process and the learning environment.
  • Support the disciplinary structures and procedures of the school, and the reasonable efforts by the school to apply discipline effectively and fairly.
  • Encourage their children to participate fully in school and extra-mural activities.
  • Participate in the learning process and assist their children with homework, provide encouragement, check results and communicate freely with the school.
  • Not expect the school to meet each child’s individual and specific needs.
  • Ensure that the learner is in attendance of all compulsory school functions and activities, and that the school’s daily timekeeping requirements and school activities are adhered to.

The Constitution states that each child has the right to an education however this is not without responsibility. The school strives to provide the educational opportunities that its students and the community deserve. Students themselves, however, must also recognize that they have responsibilities towards their parents, the school, their educators, their fellow learners and themselves.
Students therefore must accept and comply with the school rules, Code of Conduct and its conditions of enrolment. In more general terms, students must:

  • Honour the school’s Vision, Mission and Values.
  • Comply with instructions from school officials and with the general rules of the school.
  • Behave responsibly and not endanger the safety, welfare and rights of others.
  • Respect and care for the property of the school, other schools and fellow students.
  • Maintain sound relations with others at school, be courteous towards each other and elders and respect the dignity and self-worth of fellow students.
  • Be punctual and observe the timekeeping practices of the school and all school activities.
  • Demonstrate a positive attitude towards the opportunity to learn and be diligent in their efforts to learn.
  • Behave honestly and conduct themselves with integrity.
  • Not harass, threaten, violence or use force to intimidate, abuse, coerce or interfere with fellow students (emotionally or physically) via any communication media.
  • Accept legitimate disciplinary measures as per school policy taken against them as necessary where applicable.
  • The school has a number of rules that define the kinds of behaviour expected of its learners. Learners are to also keep their parents advised of these rules (please see `school rules`) and learners are expected to conduct themselves in accordance with the rules provided.
  • Declaration of Acceptance

Declaration of Acceptance: School`s Code of Conduct and Procedure & Code: Learner Discipline

By our signature we hereby declare that we have acquainted ourselves with the content and accept the Procedure & Code: Learner Discipline and Code of Conduct.


Leaner Medical Information




The admission of learners is at the sole discretion of MPS and is subject to:

1. Receipt of an acceptance letter.

2. Signing of code of conduct by parent/s or guardian and all students.

3. Signing of terms and conditions, and financial agreement.

4. MPS Benchmark test and evaluation of learner by educator for school readiness (where applicable)

5. Interview with parents and student.

6. Verification of financial information provided.

7. Payment of the enrolment fee.

8. Registration on D6 School Communicator, for school alerts, and the Staffroom In Touch Parent Portal, for school communication purposes (use the e-mail address that the school has on record for your registration).

9. Please note: a Pastel account number needs to be allocated prior to purchase of school uniform.

10. Please upload copies of the following documents: