STUDENT CARD APPLICATION NAMIBIA 2015 R3-N Student Number (Only complete if you have been issued a student number by SBS) GENERAL INSTRUCTIONS 1. 2. 3. 4. 5. Please read the instructions and complete this form in full, in block letters, to prevent unnecessary delays. ID/PASSPORT PHOTO Attach a photograph: Size = 40mm x 30mm & in colour. Proof of payment to the value of N$120.00 must accompany this form. Payment can be made by direct deposits or electronic funds transfer (EFT). Banking details: Bank: STANDARD BANK Branch: WESTGATE (016641) Account Holder: SOUTHERN BUSINESS SCHOOL Account No: 401394506 CURRENT Account 5. This form can be returned by: E-mail: bmosiane@sbs.ac.za - Important: A high resolution photograph (in colour) must be attached. Post: STUDENT CARDS, Southern Business School, Private Bag X03, Helderkruin, 1733. Remember to include your photo and proof of payment! Attach one ID/Passport size photo here, or click PERSONAL INFORMATION South African ID Number Date of Birth (YYYYMMDD) International ID Number (Applicants who are not South African citizens) Title Surname Name/s ADDRESS & CONTACT DETAILS Postal Address E-mail address Cell Phone Number Work Number Postal Code Fax Number SIGNATURE OF APPLICANT Signed at . Date (YYYYMMDD) Initials & Surname Signature . This form can be returned by e-mail to bmosiane@sbs.ac.za to prevent unnecessary delays or it can be posted to: STUDENT CARDS, Southern Business School, Private Bag X03, Helderkruin, 1733 Private Bag 13026, WINDHOEK Tel: +264 (0) 61 308 781 Fax: +264 (0) 61 308 782 e-mail: naminfo@sbs.ac.za Web site: http://sbs.ac.za Southern Business School (Pty) Ltd is registered with the Department of Higher Education & Training as a Private Higher Education Institution under the Higher Education Act, 1997. Registration Certificate Number: 2002/HE07/015