J

STUDENT NUMBER (Office use only)

CENTRE CODE

MARKETER CODE

FACILITATOR NAME (Office use only): .... VENUE (Office use only): ....
Private Bag X10, Weltevreden Park, 1715 Cnr Hendrik Potgieter Rd & 14th Ave Weltevreden Park, Roodepoort Tel: (011) 670 4700 Fax: (011) 675 2592 www.olg.co.za

APPLICATION FORM HIGHER EDUCATION

PLEASE ENCLOSE THE FOLLOWING WITH YOUR APPLICATION FORM AND TICK THE APPROPRIATE BOX: A certified copy of your identity document A certified copy of your grade 12 (Matric) certificate Certified copies of qualifications A certified copy of your marriage certificate

PERSONAL INFORMATION OF APPLICANT

Surname: First Name(s): Maiden Name (if applicable): Population Group: Title (Prof/Dr/Mr/Ms): South African ID Number: Foreign Nationality: Study Permit Number: Expiry Date of Permit: Passport Number:
(Please attach a certified copy of your passport and study permit)

Initial(s)

Asian

Black

Coloured

White Date of Birth:

Gender: Male Y Y Y Age Y M

Female M D D

Home Language: Marital Status: Contact Details: Home Tel.: Work Tel.: Fax: Cell Number: E-mail Address: Postal Address: Postal Code
Courier address for the delivery of books (if applicable to your programme choice). Available daily between 08:00 and 16:00.

Single ( ( ( C C C O O O D D D

Married E E E ) ) )

Widow/Widower

Divorced

Physical Address:

Postal Code Eastern Cape Mpumalanga Free State North West Gauteng Northern Cape Kwazulu-Natal Western Cape Limpopo

Region:

Work Address: Postal Code

Revised 2 December 2013 These programmes are offered through the Institute of Logistics and Supply Chain Management a division of OLG, the certifying body. Page 1 of 4

Relative Details:

Address: Postal Code Relationship: Home Tel.: Work Tel.: ( ( C C O O D D E E ) )

Disability: Yes
Computer Wap-Enabled Cellphone Facebook Colleagues Sales Person Technical College Web site

No

Specify: ____________________________________________________________________________ (statistics for ministry)

E-mail Telephone Cellphone Family or Friends Posters Technikon Magazines Radio Television Newspaper School University Fax Television Internet DVD Player

I have access to the following: (Mark with an X)

How did you hear about OLG? (Mark with an X)

SCHOLASTIC AND PREVIOUS QUALIFICATIONS (Mark with an X)

Grade 10 Date obtained: _________________________ Grade 12 Date obtained: ___________________________ Date obtained: ___________________________ Date obtained: ___________________________ Date obtained: ___________________________ Date obtained: ___________________________

Certificate Specify: _______________________________________________________________ Diploma Specify: ________________________________________________________________ FET: ______________________________________________________________________________f ymple Other Specify: ___________________________________________________________________

WORK EXPERIENCE (Compulsory)

Place of employment:
___________________________________________ ___________________________________________ ___________________________________________

Position held:
_________________________________________ _________________________________________ _________________________________________

Start date:
_________________________ _________________________ _________________________

End date (if applicable):

__________________________ __________________________ __________________________

PLEASE CHOOSE AN EXAMINATION CENTRE ( ) FROM THE FOLLOWING LIST:

EASTERN CAPE Bisho FREE STATE Bloemfontein GAUTENG Alberton KWAZULU-NATAL Durban MPUMALANGA Nelspruit NORTH WEST Potchefstroom NORTHERN CAPE Kimberley Bizana Welkom Germiston Empangeni (AGS) Ermelo Vryburg Kuruman Rustenburg Upington Mafikeng OLG Newcastle Pretoria Colbyn Vryheid Randfontein Springs East London Port Elizabeth

NORTHERN PROVINCE (LIMPOPO) Polokwane (Pietersburg) WESTERN CAPE George Parow

Revised 2 December 2013

These programmes are offered through the Institute of Logistics and Supply Chain Management a division of OLG, the certifying body.

Page 2 of 4

PLEASE SELECT THE PROGRAMME YOU WISH TO REGISTER FOR:

A. OLG PROGRAMMES
1. University Preparatory Programme for Logistics and Supply Chain Management 2. Higher Certificate in Logistics Management [71773] (NQF Level 5) Please select ONE specialisation/elective subject: Supply Chain Management [SUPMNGT] or Purchasing Management [PURMNGT] or

Marketing Management [MARMNGT] Year 1: Economics 1 [ECON 1] Transport Economics 1 [TRANSEC 1] Business Management 2 [BUSMNGT 2] Marketing Management 2 [MARMNGT 2] Logistics Management Systems [LOGMS] Marketing Management 2 [MARMNGT 2]

3. Diploma in Logistics and Supply Chain Management [85028] (NQF Level 6) Year 1: Logistics Business Communication [LBUSCOM] Business Management 1 [BUSMNGT 1] Logistics Management 1 [LOGMNGT 1] Supply Chain Management 1 [SUPMNGT 1] Year 2: Business Information Systems [BIS] Transport Economics 2 [TRANSEC 2] Year 3: Financial Management 2 [FINMNGT 2] Supply Chain Management 2 [SUPMNGT 2] Procurement Management 1 [PROMNGT 1] Logistics Management 2 [LOGMNGT 2] Work Integrated Learning 1 [WIL 1] Logistics Management 3 [LOGMNGT 3] Work Integrated Learning 2 [WIL 2]

4. Bachelor of Business Administration in Logistics and Supply Chain Management [91114] (NQF Level 7) Year 1: Business Management 1 [BUSMNGT 1] Economics 1 [ECON 1] Supply Chain Management 1 [SUPMNGT 1] Business Statistics 1 [BSTATS 1] Please select ONE specialisation/elective subject: Marketing Management 2 [MARMNGT 2] Year 2: Business Research [BRSRCH] Supply Chain Management 2 [SUPMNGT 2] Year 3: Business Management 3 [BUSMNGT 3] Supply Chain Management 3 [SUPMNGT 3] Logistics and Supply Chain Research: Project [RSRCH:PR] Business Management 2 [BUSMNGT 2] Financial Management 2 [FINMNGT 2]

Year 1: Logistics Management 1 [LOGMNGT 1] or Transport Economics 2 [TRANSEC 2] Logistics Management 2 [LOGMNGT 2] Economics 2 [ECON 2]

Project Management 1 [PROJMNGT 1] Logistics Management 3 [LOGMNGT 3] Logistics and Supply Chain Research: Theory [RSRCH:TH] Logistics and Supply Chain Management Systems [LOGMS]

Please note: For complete programme outline refer to your information booklet.

B.

OLG SHORT LEARNING PROGRAMMES

Introductory Logistics Management Introductory Supply Chain Management Intermediate Logistics Management Intermediate Transport Economics Introductory Transport Economics o Introductory Purchasing Management Intermediate Business Management Intermediate Supply Chain Management

METHOD OF PAYMENT (select ONE method only)

1. 2. Full amount with registration Credit card option 2.1 Total cash amount
OR 2.2 Budget account

R (5,7% levy payable) R 6 Months

. .
12 Months

Cash/EFT

Cheque

BANK DETAILS: First National Bank / Payee: Open Learning Trading Account No.: 620 111 877 98 Branch Code: 251 445 (Pretoria) Use your ID number as the reference number

18 Months

24 Months

Credit card number Expiry date of credit card Last three digits on back of credit card 3. Employer payment contribution: Will your employer be assisting you financially with respect to your studies? Yes 3.1 Company details: Name of Company: _______________________________________________________________________________________________________________ Work Address: ___________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________

M Signature of cardholder: ____________________________________________

(If so, written confirmation from your employer on a company letterhead is required together with the company VAT and Registration Numbers.)

No

Department:
_______________________________________________________________________ _______________________________________________________________________

Current Position:
______________________________________________________ ______________________________________________________

Coordinator:
_______________________________________________________________________
Revised 2 December 2013

Telephone Number:
______________________________________________________
Page 3 of 4

These programmes are offered through the Institute of Logistics and Supply Chain Management a division of OLG, the certifying body.

TERMS AND CONDITIONS

1. Open Learning Group (Pty) Ltd (OLG) with the registration number 1997/020392/07, trading inter alia as OLG, is a company who markets and sells its own programmes, as well as administrates and facilitates distance education and acts as a disclosed agent on behalf of third-party academic institutions. 2. Availability is limited for all programmes. Registration is at the sole discretion of OLG. 3. You may only register on a modular basis for specified programmes. 4. It is the responsibility of the Prospective Student to familiarise him-/herself with the requirements and the rules for each programme enrolled for, as well as to the minimum requirements in order to pass the specific programme. 5. The Prospective Student warrants that: 5.1 The information provided in the Application Form is both true and correct. 5.2 All additional documentation provided is true and correct copies of the original. 5.3 He/she acquainted him-/herself of the curriculum, the requirements and qualifications of the programme enrolled for. 5.4 If the programme for which the Student is enrolled requires practical work or internship the Student shall comply with such requirements. Initial Initial

8. All applications undergo an academic- and finance approval process. The Prospective Student consents to OLG verifying all qualifications. Once the respective requirements have been met, registration is completed, at which time the Prospective Student (then Student) will be subject to OLGs terms and conditions and rules and regulations. 9. ALL SERVICES RENDERED BY OLG SUBSEQUENT TO REGISTRATION WILL BE SUBJECT TO OLGS TERMS AND CONDITIONS, RULES AND REGULATIONS. THE OLG TERMS AND CONDITIONS, TOGETHER WITH THE STUDENT CODE OF CONDUCT, ARE AVAILABLE ON WWW.OLG.CO.ZA, IN THE OLG YEARBOOK OR ON REQUEST. ALL REQUESTS FOR THE TERMS AND CONDITIONS OR INFORMATION REGARDING THE STUDENT CODE OF CONDUCT, MAY BE DIRECTED TO OLGS CALL CENTRE ON TEL: 011 670 4850. IT IS THE Initial PROSPECTIVE STUDENTS RESPONSIBILITY TO FAMILIARISE HIM-/HERSELF WITH THESE TERMS AND CONDITIONS AND RULES AND REGULATIONS. 10. OLG MAY ON DISCRETION OF THE REGISTRAR, REGISTER A PROSPECTIVE STUDENT WITHOUT EVIDENCE OF PREVIOUS QUALIFICATIONS. HOWEVER, SHOULD THE PROSPECTIVE STUDENT FAIL TO SUBMIT THE REQUIRED DOCUMENTATION WITHIN THIRTY (30) DAYS OF REGISTRATION, THE REGISTRATION MAY BE CANCELLED WHILE THE Initial PROSPECTIVE STUDENT REMAINS FINANCIALLY LIABLE FOR ALL COSTS INCURRED PLUS A PENALTY FEE (DETERMINED ON AN ANNUAL BASIS). 11. All amendments or adjustments the Prospective Student wishes to make to his/her application and/or enrolment must be done in writing within 30 (thirty) calendar days from the signature date of the Application Form. 12. OLG reserves the right to cancel a Students registration, refuse the Student to write examination or withhold results if payment is not effected as stipulated. Qualifications will not be issued if the account is not fully paid. 13. The Student hereby directs that the relevant programme material and books be send to him/her by mail and for purposes hereof the Student appoints the Post Office as his/her agent for delivery of the programme material to him/her. The Student herewith indemnifies OLG against all liability should the Post Office fail to deliver all or part of the consignment. 14. OLG does not accept responsibility for assignments dispatched by post or otherwise. It is the responsibility of the Student to ensure that assignments reach OLG timeously. 15. The Student is responsible to thoroughly check and verify the educational material and books received from OLG within seven (7) calendar days from date of the delivery note. If the content differs from the included control sheet, the Student shall notify OLG in writing accordingly. If no notification is received from the Student and the Student alleges that not all material and/or books were received, the Student undertakes to be fully liable for whatsoever cost occurred to resend any material and/or books. 16. A Certificate signed by the accountant of OLG will be prima facie proof of indebtedness to OLG and the Certificate may be used for purposes of instituting action and Judgement. 17. OLG may cede or assign the rights contained herein at any time to any institution without the prior consent of the Student. 18. The address provided in the Application Form by the Student, is his/her address for purposes of delivering legal notices or communications related to the agreement between him/her and OLG. The Student undertakes to notify OLG of any change in address in writing by prepaid registered post or fax. 19. It is the responsibility of the Student to avail him-/herself of all exam times and venues and/or programmes enrolled for. 20. Subject Credits may be applied for within the guidelines set by OLG and subject to payment of the prescribed fees. 21. OLG absolves itself from any claim where a qualification is not recognised by the Department of Education. In a case where a Student had falsely claimed to be in possession of a previous qualification or any other requisite entry requirement, the Student will automatically be de-registered without repayment of fees. 22. THE STUDENT ACKNOWLEDGES THAT HE/SHE IS FULLY LIABLE FOR ALL FEES AND COSTS IN RESPECT OF THE ENROLMENT OF A PROGRAMME AND ACCEPTS Initial RESPONSIBILITY FOR PAYING THE FULL PROGRAMME FEE ON/BEFORE THE STIPULATED DATES. 23. A PROSPECTIVE STUDENT MAY CANCEL HIS/HER APPLICATION WITHIN 7 (SEVEN) DAYS FROM DATE OF RECEIPT OF THE APPLICATION FORM BY OLG WITHOUT ANY CANCELLATION CHARGES. AS A RESULT OF LIMITED AVAILABILITY IN ALL PROGRAMMES AND NOT LIMITING THE STUDENTS LIABILITY HEREIN, CANCELLATION SUBSEQUENT TO THE Initial INITIAL 7 (SEVEN) DAYS SHALL BE SUBJECT TO A CANCELLATION CHARGE (AS DETERMINED ON AN ANNUAL BASIS). 24. No variation or amendment to or waiver of any rights or cancellation hereof will be valid unless in writing and issued and signed by an authorised representative of OLG (except in the event of an increased programme fee). 25. THE STUDENT HEREBY CONSENTS TO THE JURISDICTION OF THE MAGISTRATES COURT AND ACKNOWLEDGES THAT HE/SHE IS LIABLE FOR ALL COSTS, INCLUDING COSTS ON AN ATTORNEY AND OWN CLIENT SCALE SHOULD THE PROGRAMME FEES NOT BE PAID ACCORDING TO THE METHOD OF PAYMENT SELECTED IN THE APPLICATION FORM Initial WITHIN 30 (THIRTY) DAYS OF REGISTRATION. ALL AMOUNTS PAYABLE ARE EXCLUSIVE OF COSTS, INCLUDING BANK COSTS AND NO SET-OFF MAY BE APPLIED. 26. It is specifically recorded that all intellectual property rights whatsoever, whether capable of registration or not, including but not limited to OLGs name, nickname, educational programmes, study material, logo and/or image shall remain the sole property of OLG. The Student acknowledges and agrees to be liable for a penalty of R100 000.00 if it is found that the study material of OLG under his/her supervision has been copied or reproduced. If the damages and expenses incurred by OLG exceed the total amount of the penalty payable in terms of this clause, the Student shall be liable for the balance of the damages and expenses incurred by OLG due to unlawful infringement. 27. OLG, its directors, employees or its service providers will not be liable for any special, direct, indirect or consequential damages, expenses or losses whatsoever, including loss of profits or data, any delays, whether in an action in contract or delict, arising out of the use of OLGs educational programmes, study material and/or books. 28. The Student hereby consents and grants authority to OLG to conduct credit checks, searches and the like with any credit agency or party for the purpose of ascertaining the credit worthiness of the Student and/or account holder. 29. No failure by either Party to enforce any provision of this Agreement shall constitute a waiver of such provision or affect in any way a Partys right to require performance of any such provision at any time in the future, nor shall the waiver of any right arising from any subsequent breach nullify the effectiveness of the provision itself, or be used as an estoppel against any party in respect of its rights under this Agreement. 30. WITH THE SIGNING OF THESE TERMS AND CONDITIONS THE STUDENT GIVES OLG PERMISSION TO UPLOAD HIS/HER RESULTS TO THE NATIONAL LEARNERS RECORDS Initial DATABASE (NLRD) AS PER THE REQUIREMENT SET BY THE DEPARTMENT OF HIGHER EDUCATION AND TRAINING (DHET). STATEMENT AND UNDERTAKING I, ________________________________________________________________ (FULL NAMES & SURNAME) CONFIRM THAT I HAVE READ THE TERMS & CONDITIONS AND FULLY UNDERSTAND IT AND THAT I SHALL FURTHERMORE PERSONALLY BE LIABLE FOR THE PAYMENT OF MY ACCOUNT OR ANY PENALTY COST OR ADMINISTRATION COSTS AS STIPULATED ABOVE. THUS DONE AND SIGNED AT _______________________________________________________________ ON THIS __________________ DAY OF ______________________________________________________ 20_________

6. THE STUDENT HEREBY CONFIRMS THAT ALL DOCUMENTATION SUBMITTED IS VALID AND AUTHENTIC. 7. OLG REMAINS ENTITLED TO RECOVER ALL COSTS INCURRED FROM THE STUDENT FOR FRAUDULENT DOCUMENTATION SUBMITTED.

__________________________________________________

PROSPECTIVE STUDENT

__________________________________________________

OPEN LEARNING GROUP REPRESENTATIVE

FOR OFFICE USE ONLY Academic approval: Approved Declined Signature : ____________________________________ Date: __________________________

Reason for academic decline: __________________________________________________________________________________________________________________ Fees received: Receipt number:

Revised 2 December 2013 These programmes are offered through the Institute of Logistics and Supply Chain Management a division of OLG, the certifying body. Page 4 of 4

Cash

Cheque

Direct deposit

Debit order

Stop order

Credit card