First Name/s*

ID Number*

Residential Address*

Email Address*

Contact Number 2

Next Of Kin*
GuardianSpouseParentPartner

Next of Kin Last Name*

Next of Kin Contact Number 2

Do you have your own Laptop/Computer?*
YesNo

Laptop/Computer Owner Name

Computer Owner Contact Number

Do you have access to a stable Wi-Fi / Data / Fiber connection?*
YesNo

Are you Currently Employed?*
YesNo

Have you Matriculated?*
YesNo

Year Matriculated

Are you Currently Studying?*
YesNo

Are you:*
SingleMarriedDivorcedWidowedPartnered

How many children?

Do you have 6 to 8 hours per week to dedicate to this program?*
YesNo

What Religion Do You Subscribe to?*
MuslimChristianTraditionalJudaismNoneOther

I agree and commit to completing the online 12-month bursary program.*
I Agree

I attest that I have access to a laptop/computer and wifi/fibre/internet/data.*
Yes

I consent to IT Varsity contacting me via voice calls and/or electronic communication for the purposes and fulfilment of this bursary.*
I Agree

I understand that the standard course fee is R600.00 per month.*
I Agree