Khanyisa Nursing College

Official Online Application Portal

Important: Please complete the entire application form below. All fields marked with * are required. Your complete application will be submitted in ONE email when you click "Submit Application".

1

Personal Details

2

Contact Info

3

Family Details

4

Programme

5

Education

6

Documents

7

Declaration

8

Submit

Mobile-Friendly: This form is optimized for all devices. You can complete your application on your phone, tablet, or computer.

Complete Application Form

Please complete all sections below. All fields marked with * are required. Your application will be submitted in one complete email when you click "Submit Application".

Full Name (as per ID) *
South African ID Number *
Date of Birth *
Gender *	Male Female Prefer not to say
Nationality *
Applicant Phone Number *
Alternative Phone Number
Email Address *
Physical Address *
Parent/Guardian Full Name *
Relationship *
Parent/Guardian Phone Number *
Alternative Parent/Guardian Phone Number
Full Name of Next of Kin *
Relationship *
Contact Number *
Programme Applying For *
Intake Period *
High School Name *
Year Completed *
Subjects Passed *
Upload Matric Certificate *	Max file size (Mb): 5 Max number of files: 1
Certified ID Copy Upload *	Max file size (Mb): 5 Max number of files: 1
Proof of Residence Upload *	Max file size (Mb): 5 Max number of files: 1
Additional Documents (Optional)	Max file size (Mb): 5 Max number of files: 1
Declaration *	I confirm that all information provided is true and correct I understand that false information may lead to disqualification I agree to the terms and conditions of Khanyisa Nursing College
Digital Signature *
Date *