Western Cape Education Department

Directorate: Examinations
Private Bag x9114 Cape Town 8001
Exam.Results@westerncape.gov.za
(International Code: +27) Tel: 0861 819 919 (Option 2)

Price Valid: 1 April 2023 to 31 March 2024 Office use only

Bank: NEDBANK
Account Name: Provincial Government
Western Cape Education
Department
Account Type: Current Account
Account number: 1452 045 089
Branch Name: NEDBANK CORPORATE APPLICATION FOR (please mark in block with) X
Branch number: 145 209 (a) Confirmation of Results (Statement) R 57, 00

N.B.: Please complete “ Deposit Reference” on de- (b) Combine different Results (1st Issue) R 164,00
posit slip (15+ID Number)
PLEASE SUBMIT BANK DEPOSIT SLIP WITH FORM (c) Replacement (SC/NSC) Certificate R 164,00

Please note: The following documentation must accompany your application:

1. Certified copy of your identity document
2. Proof of payment

PERSONAL INFORMATION
Surname Married
(at time of Exam) Surname
Full Names
Date of Birth Id No
Address Tel No
Cell No
Email
Postal Code Email

Year of Examination School/College attended

Full/Part Time Province written
Exam Number (if available)

SUBJECTS WRITTEN AT EXAMINATION

IF ANY OTHER EXAMINATIONS WRITTEN, PLEASE COMPLETE BELOW:

Year / Month Examination number Subject(s) Name of school/college/ province

NB. If the above-mentioned information and documentation are not provided, this application cannot be processed.

Certificate WILL NOT BE POSTED. Applicant will be notified for collection.

SIGNATURE: DATE:
 Wes-Kaap Onderwysdepartement
Direktoraat: Eksamens
Privaatsak x9114 Kaapstad 8001
Exam.Results@westerncape.gov.za
(Internasionale Kode: +27) Tel: 0861 819 919 (Opsie 2)

Pryse Geldig: 1 April 2023 tot 31 Maart 2024 Slegs vir kantoorgebruik
Bank: NEDBANK
Rekening Houer: Provinsiale Regering
Wes-Kaap Onderwysdepartement

Tipe Rek. Lopende Rekening

Rek. Nommer: 1452 045 089
Taknaam: NEDBANK CORPORATE
AANSOEK OM (merk asseblief in blok met) X
Takkode: 145 209 (a) Bevestiging van Uitslae (Staat) R 57, 00
LW: Voltooi asseblief “ Depositoverwysing” op
deposito vorm(15+ID Nommer) (b) Kombineer verskillende uitslae R 164,00

VOORSIEN DEP STROKIE MET AANSOEK (c) Vervanging (SC/NSC) Sertifikaat R 164,00

Let wel: Die volgende dokumentasie moet u aansoek vergesel:

1. `n Gewaarmerkte afskrif van u identiteits dokument.
2. Bewys van betaling

PERSOONLIKE BESONDERHEDE
Van Getroude
(ten tye Eksamen) Van
Volle Name
Geboorte Datum Id No
Adres Tel No
Sel No
Epos
Poskode Epos

Jaar van Eksamen SKOOL/KOLLEGE BYGEWOON

Voltyds/Deeltyds PROVINSIE WAAR VOLTOOI
EKSAMENNOMMER

VAKKE GESKRYF TYDENS EKSAMEN

Indien enige ander eksamens afgelê voltooi hieronder:

Maand en jaar Eksamennommer Vak(ke) Naam van skool en provinsie

LW: Hierdie aansoek kan nie geprossesseer word sonder die bogenoemde informasie en dokumentasie nie.
Sertifikaat SAL NIE GEPOS WORD NIE. Applikant sal ingelig word vir die afhaal daarvan.

HANDTEKENING: DATUM: