StemLab Online Enrollment Portal Please fill out the enrollment form to be considered for our programs. LEARNER PERSONAL INFORMATIONTitle *TitleMrMrsMsOtherFull Names *Date Of Birth *Gender *MaleFemalePhone Number (Learner)Email Address *Current School *Grade *Learner Status *Learner StatusNewExistingAny medical conditions? *YESNOIf Yes describeAny physical or learning disabilities? *YESNOIf Yes Please DescribePARENT /GUARDIAN PERSONAL INFORMATIONTitle *TitleMrMrsMsOtherFull Names *Occupation *Employer *ID Number *Work Phone Number *Mobile Number *Email Address *Street AddressPostal AddressEMERGENCY CONTACT DETAILSTitle *TitleMrMrsMsOtherFull Names *Mobile Number *Work Phone NumberEmail Address *Relationship *INDIVIDUAL RESPONSIBLE FOR FEESTitle *TitleMrMrsMsOtherFull Names *Occupation *Employer *ID Number *Work Phone Number *Mobile Number *Email Address *Relationship *PAYMENT METHODCampus *Select OneTygervalley CampusClaremont CampusSelect your modality of learning *Full-TimeOnlineMethod of Payment *Full Tuition FeesMonthlyMonthly Installments3 x Months6 x Months9 x MonthsIf Monthly Select HowPayment Method (Banking Details: FNB / ACC No: 63116114602 / BRANCH CODE: 204209) *EFTCARDNotesCOURSE SELECTIONSelect Course Of Interest *Robo - Kids (6 - 9) - 12 Month MembershipCoding - Kids (10 - 11) - 12 Month MembershipWhizz - Kids ( 13 - 15) - 12 Month MembershipMaster - Kids (16 - 18) - 12 Month MembershipHARDWARE SELECTION *Robotics & Coding Kit ( Compulsory)Laptop / iPAD ( Compulsory)Apparel & OHS Kit3D Printer3D MouseHeadsetRequired items for registration can be purchased here www.shop.stemlab.co.za.SUPPORTING DOCUMENTATIONID OF APPLICANT / PASSPORT OF PAYEE *Choose FileNo file chosenDelete uploaded fileProof of Payment *Choose FileNo file chosenDelete uploaded fileSTEMLab Registration Terms and ConditionsConsent *Yes, I agree with the terms and conditions. Submit ApplicationPlease do not fill in this field. Go Back Home
