COVERSHEET 201… APPLICATION FOR SUBSIDY - GRADE R CLASS Name of school Term 1 2 3 4 District EMIS NO COVER SHEET Have you completed and included the following documentation with your application? Documents attached: (check your documents by ticking each block) Annexure A Annexure C Annexure D One Annexure for all the Grade R expenses. Attach Annexure C1 One Annexure for all Grade R classes. Annexure B This is a SUMMARY One One Annexure per Annexure for Grade R class. all the Grade R classes. Registers CEMIS One per Grade R class One list per Grade R from the class. previous subsidy date. Salary Advice UIF & SARS Proof of payment to One advice the relevant per Grade R departments educator. for these amounts. . Receipts for purchases Attach all receipts to Annexure C 1. Complete for Grade R practitioners / educators only: TEACHER INFORMATION - please print Teacher 1 Full Name…………………………………………………….. ID No………………………………… Teacher 2 Full Name…………………………………………………….. ID No………………………………… Teacher 3 Full Name…………………………………………………….. ID No………………………………… Teacher 4 Full Name…………………………………………………….. ID No………………………………… Principal : Date Thank you for your co-operation ANNEXURE A 201 APPLICATION FOR PAYMENT OF SUBSIDY – GRADE R CLASS Term 1 2 3 4 COLLECTION OF SCHOOL FEES? NQ 1 2 3 4 5 PARTICULARS Name of institution: NO YES EMIS NO: Street address: Postal address: Postal code Postal code: Education district: Circuit: Full Name of principal: Telephone number: Code number FAX Email address: ENROLMENT / INSKRYWING: Summary of all pupils in Grade R in the school Age (no learners younger than 4½ years old) Boys Girls Total 4½ turning 5 years old this year: born between January and June 5 turning 6 years old this year: born between January and December 6 turning 7 years old this year: attach exemption letter to this form Total Number of Grade R classes Circle 1 2 3 4 5 Number of learners per class SIGNATURE OF PRINCIPAL APPLICATION FOR SUBSIDY: DATE RECOMMENDED / NOT RECOMMENDED DCES:ECD CIRCUIT MANAGER _____________________________________________ DATE ______________________ IMG HEAD: _____________________________________________ DATE ______________________ 6 7 8 ANNEXURE B 201 APPLICATION FOR PAYMENT OF SUBSIDY – GRADE R CLASS Term 1 2 3 4 Name of institution: Grade R Class Name Address of institution: Commencing date of quarter/ Closing date of quarter/ Total number of days on which school was held/ (PLEASE ATTACH A COPY OF ATTENDANCE REGISTER FROM THE LAST CLAIM DATE ) Indicate dates on which institution was closed during quarter/ Surname and Initials of learner Date of Birth Maximum claim 30 learners per class Surname Initials Attach EXEMPTION FORM if applicable Day Month Date of admission of learner to Institution Year If a learner left during the term, state the date of withdrawal from institution/ Number of days on This column to be left which learner blank for Departmental actually attended the use/ . institution during the term/ 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. I certify that the above particulars are derived from the enrolment and attendance registers maintained in accordance with the requirements of the Western Cape Education Department and that the particulars are true and correct. Signature on behalf of Governing Body/ Name in print/ Capacity/ Place/ ANNEXURE C 201 GRADE R CLASS/ES: FINANCIAL STATEMENT OF RECEIPTS AND EXPENDITURE Term Name of institution: Registration number: (WCED Certificate Number) Commencing date of quarter Closing date of quarter INCOME This is money that has been received Description Amount Date When was money received Where did the money come from Balance Brought Forward Explanation How much money was received Fill in that amount here WCED Subsidy Did you receive further payment from WCED? Fill that in here R Remember: this amount has to last for the next 2 terms School fees Date When was money spent How much money was left from the last subsidy payment? R EXPENDITURE This is money spent Description Amount Educator/s Salary (80% of subsidy) Month How much money has been raised this term? R R 2 R 3 1. LTSM Sponsorship Do you receive any financial support from other sources? R Total R More than 4 educators? Use an additional form. - UIF is deducted every month SALARY TOTAL (10%) R R LTSM TOTAL Claim running costs of Grade R class/es if necessary. R TOTAL EXPENDITURE - R Subtract 4. TOTAL EXPENDITURE from TOTAL INCOME Telephone R R This is the amount to be carried forward to next subsidy application. Water & Electricity R Copying & Printing R Cleaning materials R Maintenance R 3. TOTAL FROM OTHER R OTHER Signature: Date: Capacity: Attach RECEIPTS to this application R TOTAL INCOME Drafted by: (full name) This is all equipment & materials used in teaching Furnish RECEIPTS to prove expenses have been paid. - Attach Annexure C1 for expenses here Insert Annexure C1’s total/s at 2. LTSM TOTAL 2. CLOSING BALANCE Fill in the Gross Salary of the teacher here Include top-ups & allowances etc This should be reflected on educator’s salary advice. R 1 less UIF of 1% Fundraising Explanation How much money was paid Who was paid with this money How much money has come in this term in school fees? R 1 2 3 4 (10%) – Attach receipts 4. TOTAL EXPENDITURE Add totals 1+2+3= 4 R We the undersigned, hereby certify we have verified all the books and statements relating to the above entries and confirm that this statement is a true reflection thereof. Signature of the Principal: Full Name in Print: Date: Signature of the Chairperson of the School Governing Body Full Name in Print: Date: ANNEXURE C1 201… GRADE R EXPENSES SPREADSHEET NAME of SCHOOL: Date 17 10 13 Page___ of ___ ATTACH ALL RECEIPTS TO THIS SHEET GRADE NAME: TERM 1 2 3 4 Item and quantity Name of Supplier Receipt number For what purpose will this material be used? eg classroom, office, cleaning, telephone, electricity etc Amount paid 3 reams white A4 paper Pick 'n Pay 33479 Classroom R 90.00 ▲SEE EXAMPLE ABOVE ▲ ▲SEE EXAMPLE ABOVE ▲ ▲SEE EXAMPLE ABOVE ▲ TOTAL Completed by : (Print full name ) Signature of the Principal: Signature: Date: Signature of the Chairperson of the Governing Body Full Name in Print: Full Name in Print: Date: Date: ANNEXURE D WCED 096 201… CERTIFICATE OF SOUND FINANCIAL MANAGEMENT Term 1 2 3 4 Name of Educational Institution: ________________________________________________ Type of Educational Institution: Public High Other F F F Independent F Combined F Primary F Preprimary F ………………………. Education District: ____________________________ CEMIS NO.: __________________ NUMBER OF QUALIFYING GRADE R LEARNERS AT SCHOOL THIS TERM YES NO THE SCHOOL FUNCTIONS ACCORDING TO THE S.A. SCHOOLS ACT 1996 (Act 84/ 1996) We, the undersigned, hereby certify that the institution implements effective, efficient and transparent financial management and internal control systems (Section 38(1)(j) of the Public Management Finance Act, 1999 (Act 1/1999 as amended by Act 29/1999). CHAIRPERSON OF GOVERNING BODY FULL NAME DATE SIGNATURE print PRINCIPAL OF INSTITUTION FULL NAME (print SIGNATURE DATE SURVEY 2014 SURVEY : NEW ANNEXURE FORMAT SURVEY 2014 SURVEY : NEW ANNEXURE FORMAT 1 = difficult to complete 2 = some parts were difficult to understand 3 = about the same as the previous forms 4 = easier to complete 5 = clear, simple and easy to complete WE VALUE YOUR INPUT IN AN ATTEMPT TO MAKE THESE FORMS AS USERFRIENDLY AS POSSIBLE. 1 = difficult to complete 2 = some parts were difficult to understand 3 = about the same as the previous forms 4 = easier to complete 5 = clear, simple and easy to complete WE VALUE YOUR INPUT IN AN ATTEMPT TO MAKE THESE FORMS AS USERFRIENDLY AS POSSIBLE. NAME OF SCHOOL: NAME OF SCHOOL: 1 2 3 4 5 Comments 1 COVER SHEET COVER SHEET ANNEXURE A ANNEXURE A ANNEXURE B ANNEXURE B ANNEXURE C ANNEXURE C ANNEXURE C1 ANNEXURE C1 ANNEXURE D ANNEXURE D SUGGESTIONS: SUGGESTIONS: 2 3 4 5 Comments