ANNEXURE A1

APPLICATION FOR EXEMPTION OF LEARNER TO ATTEND SCHOOL

[Application in terms of directions 6(1)(a), 6(1)(b), 6(1)(c), 6(2)(a), 6(2)(b), 9(6)(b)(i) and 9(6)(b)(ii)]

(To be completed by the parent/caregiver/designated family member)

I, _________________________________________ (Name and surname), the parent, caregiver or a designated family member (delete whichever is not applicable) of ______________________________ (Name of learner) who is in Grade _______ at ____________________________________________________(Name of school), hereby apply to the Head of Department to exempt the learner from compulsory school attendance, in terms of section 4 of the South African Schools Act, 1996 (Act No. 84 of 1996), for the period of the national state of disaster.

I do so, and take full responsibility, to oversee the learning of the learner at home as indicated in the signed agreement (Annexure A2). The reasons for my application for exemption are as follows:

In respect of a learner contemplated in direction 6(1)(a): Evidence of medical condition of learner is attached/not attached (delete whichever is not applicable).

In respect of a learner contemplated in direction 9(6), the parent/caregiver/designated family member of the learner must, in terms of direction 9(6)(b)(ii), specify the support needs of the learner in respect of teaching and learning material, assistive devices or therapeutic services, as follows:

Signed at ___________________________ on this _____________ day of____________________2021