Student Number:
Name:
Surname:
Sex:
Home/first language:
Current course if student:
Year:
Faculty:
Department:
Email address (e.g. student email) s213456789@mandela.ac.za:
Please share why you are interested in being part of this module, and what are you looking forward to learning or experiencing through it (50 words max):
Which campus are you in:
Tutorial Slot (Tick check box) select only one slot:
POPIA information:
The Protection of Personal Information Act, 2013 (POPI Act) has been promulgated and implemented on 1 July 2020. All personal identifiable information provided by you shall be treated in accordance with this statute and only used for academic and academic administration purposes, as indicated in the University’s Privacy Policy. By providing your information, you are giving consent for the use of all your personal identifiable information, provided to the University, for the aforesaid purposes.