DEBIT ORDER FOR STUDY FEES 2015 R2 Student Number (Only complete if you have been issued a student number by SBS) GENERAL INFORMATION AND INSTRUCTIONS 1. Southern Business School (Pty) Ltd offers our students an interest free payment option for study fees. 2. Please complete this form in full, in block letters, to prevent unnecessary delays. 3. Please note that the REGISTRATION FEE for all qualifications DOES NOT FORM PART of this debit order payment option and must be paid up front with registration. 4. Please ensure that sufficient funds are available in your account on the 15th or 30th day of every month. A fee of R145 will be charged on all rejected debit orders. 5. Please return the completed form by fax for attention: Ms L Prinsloo to fax number: +27 (0) 86 586 6969 or it can be posted to: The Finance Department, Private Bag X03, Helderkruin, 1733. QUALIFICATION Higher Certificate Diploma Advanced Diploma Bachelor of Business Administration Degree BBA Honours Bachelor of Policing Practice Degree BPP Honours 2 SUBJECTS PER SEMESTER R476 per month R476 per month R594 per month R560 per month R754 per month R500 per month R690 per month 3 SUBJECTS PER SEMESTER R715 per month R715 per month R890 per month R830 per month R1 130 per month R760 per month R1 050 per month I hereby authorise Southern Business School to deduct from my bank account the following: South African ID Number International ID Number (Applicants who are not South African citizens) Birth Date (YYYYMMDD) Title Initials Surname Name of Account Holder Bank Name (e.g. Standard Bank) Branch Name (e.g. Westgate) Branch Code (e.g. 01664100) Account Number (e.g. 401394506) Type of Account (e.g. Savings, Cheque) If you have a savings account, please enquire at your bank if debit order deductions are allowed on your savings account. Amount to be deducted every month on the weekday closest to the 15th or 30th until further notice is given in writing: On the 15th On the 30th I declare that the information provided are valid and correct and I agree to all the registration conditions. Signed at Date (YYYYMMDD) Initials and Surname Signature This form MUST BE ATTACHED to the Registration Form Private Bag X03, Helderkruin, 1733 / Tel: +27 (0) 11 662 1444 / Fax: +27 (0) 11 662 1462 / e-mail: info@sbs.ac.za / Web site: http://sbs.ac.za Southern Business School (Pty) Ltd is registered with the Department of Higher Education & Training as a Private Higher Education Institution under the Higher Education Act, 1997. Registration Certificate Number: 2002/HE07/015