Gas Regulator Levies Act, 2002
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Disaster Management Act, 2002 (Act No. 57 of 2002)RegulationsRegulations issued in terms of Section 27(2) of the Disaster Management Act, 2002 (COVID-19)AnnexuresAnnexure A : FormsForm 3A : Certificate for learners or students to travel to another province/metropolitan area/district |
FORM 3A
CERTIFICATE FOR LEARNERS OR STUDENTS TO TRAVEL TO ANOTHER PROVINCE/METROPOLITAN AREA/DISTRICT
Regulation 34(5)
Note: This certificate and an identity document/drivers licence must be in the possession of the learner/student to whom this certificate is issued
I,
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Full names: |
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Surname: |
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Identity number: |
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Name of school/institution: |
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Address of school/Institution: |
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Province of school/institution: |
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Metropolitan area/district of school/institution: |
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Contact details: |
Cell nr. |
Tel No (h) |
e-mail address |
In my capacity as *Head/delegated person of the above-mentioned *school/institution, hereby declare that the undermentioned *learner/student, is a *learner/student at this *school/institution, and needs to travel between different *provinces/metropolitan areas/districts for education
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Full names of learner/student: |
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Surname of learner/student: |
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Residential address: |
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Province of residence: |
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Metropolitan area/district of residence: |
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Full names of primary caregiver: |
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Contact details of primary caregiver: |
Cell nr. |
Tel No (h) |
e-mail address |
Signed at ___________ on this _____________ day of____________________2020
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_____________________________ |
Official stamp |
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*Head/delegated person of *school/institution |
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[Form 3A inserted by section 7(a) of Notice No. 608, GG43364, dated 28 May 2020]
