Application Form

ENQUIRIES
  • Tel: (021) 638-1121
  • Fax: (021) 638-1790
  • info@ipsa-edu.org
  • www.ipsa-edu.org
ENQUIRIES
  • International Peace College South Africa
  • Cnr Johnston & Duine Road, Rylands Estate
  • Cape Town 7764
APPLICATION CRITERIA
  • 1. All information in this application will be treated confidentially.
  • 2. Only ONE application form per applicant.
  • 3. Please read the instructions carefully and complete all sections.
  • 4. Incomplete forms will not be processed.
  • 5. A NON-REFUNDABLE application fee must accompany this application.
  • 6. A non-refundable penalty for late applications will apply.
  • 7. All copies of documents attached to be duly certified.
  • 8. Should the stipulated space be insufficient, please attach details on a separate sheet.
  • 9. Students registered at IPSA are not allowed to be simultaneously registered and studying at any other institution.
  • 10. Students who work part-time or after classes may be advised to defer a selection of subjects, thus extending the Higher Certificate Islamic Studies (HCIS) programme over the minumum 3years, and Bachelor of Arts Islamic Studies (BAIS) degree programme over the minimum 5years. Consult the Examinations & Records Department herein.
  • 11. All applicants to accept the rules and regualtions accompanying this application, as well as the terms and conditions herein.
  • 12. All applicants to make an appointment for an interview with the IPSA Enrolment Officer, drebrahim@ipsa-edu.org

Programme Details

Please indicate if any of the following is applicable:

Applicant's Personal Details

Marital Status

Address Details

Mother/Guardian Next of Kin Details

Father/Guardian Next of Kin Details

Other Particulars

Acadmic History

Supply full details of studies at higher education institution(s). The following are regarded as higher education institutions: universities, previous technicon, and teachers' training and technical colleges.In the event of discontinuation of studies, indicate the date of cancellation.
Year FromYear ToHigher Education InstitutionField of Study(e.g.BA,BCom,MSc.)Student NumberResult (e.g.cancelled,failed,degree obtained)

South African Matric Details

Indicate the highest grade passed

High School Details

Islamic Education History

Credits/Deferment

Medical Condition

The College must be informed of certain disabilities in order to determine whether it is able to make special arrangements to accommodate persons with such disabilities. It is the prospective student`s responsibility to inform IPSA and to make a declaration to the relevant professional board/s in this regard.

List contact details of an emergency contact in the case of an emergency.

Person responsible for fees

Alternate Contact Person

1. Terms and Conditions

1. FINANCIAL DETAILS

DEPOSITS & PAYMENTS:

You must retain your original proof of payment and only a copy must accompany your application form.

Please note that it is mandatory upon registration to sign the IPSA Fees Policy and Debit Order documentation.

Please utilize STUDENT NUMBERS as your DEPOSIT SLIP REFERENCE on bank deposit slips, OR the Electronic Funds Transfer (EFT), OR the Website Paypal feature.

2. LEGAL DECLARATION OF INDEMNITY OF THE INTERNATIONAL PEACE COLLEGE

SOUTH AFRICA [IPSA] OF RYLANDS ESTATE 7764
  • 2.1 Neither the College or any employee or representative of the College acting in his/her capacity as much as shall be liable for:
  • i) Any damage arising out of the death, bodily injury, loss of health or illness of any student or the destruction of or damage to any property owned by or in custody of any student, or
  • ii) Any loss of a purely pecuniary nature suffered by any person whatsoever, whether such damage be caused by the negligent or intentional act or omission, or any other wrongful act or omission of the College or any employee or representative of the College, or arising out of the ownership of any domesticated animal.
  • 2.2 The applicant hereby indemnifies the College against any claim made by any person whatsoever against the College in respect of any damage arising out of the negligent or intentional act or omission or any other wrongful act or omission of the applicant.

3. COMPLETION OF SECTIONS A, B & C IS MANDATORY

SECTION A: I, the undersigned applicant:-
  • 3. 1 Declare and warrant that I am a major / a minor assisted as far as in law required by my parent/ legal guardian in his/her capacity as my guardian.
  • 3.2 Acknowledge and understand the provisions of the declarations of indemnity above and hold myself bound thereby; and by other provisions by this application; and by the rules and regulations of the College for the time being in force or as may be altered, during the orientation period and for any period during which I am a registered student; and by the rules and regulations of the College for the time being in force or as may be altered or of any College residence to which I may be admitted.
  • 3.3 Declare that I know that , should I during my attendance at the College undergo training in any workshop, laboratory or any other place of training or education, or attend any excursion, exercise, sporting activity, event of any nature whatsoever or gathering whether authorized by the College or not and whether authorized by law or not, whether within or outside the College, I may be exposed to risk to life or bodily injury or to health or illness or of damage to property, and that, in the full knowledge of this I consent to run all the risks involved in any such training, excursion, sporting activity, event or gathering.
  • 3.4 I accept herewith that with my signature on this document IPSA will have the undisputed and uncontested right to verify any information in this application form or any document submitted herewith by any means it deems fit.
  • 3.5 I further accept by signing this document, I am bound unconditionally to all rules and regulations of IPSA, nothing excepted, and that it is my duty to familiarize myself with all such rules and regulations.
  • 3.6 Certify that the information given in this form is accurate and complete.
SECTION B
  • TO BE COMPLETED BY THE PERSON WHO WILL BE RESPONSIBLE FOR THE PAYMENT OF FEES, NAMELY:-
  • i) the applicant, or,
  • ii) the parent or guardian, or
  • iii) another person who has undertaken to be responsible
  • SURETY

    I/We the signatory/signatories (hereinafter referred to as the “surety/ies”) to this agreement, other than the student, hereby bind myself/ourselves as surety/ies and co-principal debtor/s jointly and severally for and with the student (the principal debtor) in solidum in favor of the International Peace College South Africa (IPSA) for the payment of all debts and due fulfillment of all obligations of whatever nature and however arising which the student may now hereafter owe to IPSA. Signing of this document is acceptance of the legal declaration of terms and conditions.

    SECTION C

    CONSENT

    PLEASE READ AND SIGN THE FOLLOWING CONSENT TO COLLECT PERSONAL INFORMATION:

2. Rules and Regulations

A. AGREEMENT

I, the undersigned, hereby register as a full- time/ part- time student of the International Peace College South Africa (IPSA), situated on the Cnr of Johnstone and Duine Roads, Rylands Estate, Athlone, Cape Town – Western Cape 7764: Subject to the following terms and conditions:

1. General rules and regulations of IPSA under this agreement

  • 1.1 I hereby undertake to acquaint myself, abide by and comply with the IPSA Statute, all the rules, regulations, policies and procedures of IPSA as amended from time to time.
  • 1.2 I agree that IPSA, through its normal governance bodies, may amend rules, regulations, policies or procedures, and that I shall be bound to such amendment as soon as it may take effect.
  • 1.3 I agree to update my personal details by lodging it with the Examinations and Records Office if they change during my period of study at IPSA.
  • 1.4 I agree to update my academic details by lodging it with the Examinations and Records Officer if it changes during my period of study at IPSA.
  • 1.5 I agree to submit a doctor’s certificate in case of illness that may or may not result in my absence. I am aware that such certificates need not specify the nature of the illness.
  • 1.6 I agree to adhere to the dress- code of the college, which requires that all students adhere to a modest dress code whereby the awrah must be covered. The preferred dress- code for females is the black abāyah and ḥijāb covering all the hair and neck area, and white full length thawbs and fezzes for the males.
  • 1.7 This dress- code applies to faculty outings as well.
  • 1.8 I am well informed that free mixing of the opposite genders is not permitted in Islam, and I will thus maintain the decorum of the Sharī’ah when interacting with my class-mates and IPSA staff, both males and females.
  • 1.9 I am hereby informed that the college and its grounds is a smoke free zone. I will thus adhere to the non- smoking rule at all times.
  • 1.10 I am aware that failure to adhere to these rules may result in the implementation of disciplinary action, which may be in the form of a warning, suspension or immediate expulsion; depending on the severity of the misconduct.

2. Course content, Certificates and relevant documents

  • 2. 1 I agree that any change to my registered modules/courses/subjects must be applied for in writing to the ER Office and must be sanctioned by the relevant HOD and approved by the Deputy Principal (Academic) of IPSA and can only be implemented when finally approved as stated. I accept that all such changes must conform to the requirements, rules and regulations of the Department of Higher Education & Training of South Africa as may be current at any given time.
  • 2. 2 I agree to update my academic details by lodging it with the Examinations and Records Officer if it changes during my period of study at IPSA.
  • 2. 3 I agree that IPSA has the right to cancel my registration if I provide incorrect information or documentation in an application for admission and registration, that may constitute a criminal charge of fraud, (including but not limited to the official certificate in respect of my IPSA admission, any previous study record, and certificate of conduct) or if I fail to provide information or documentation that substantiates the qualification(s) listed.
  • 2. 4 I further agree that should I bring IPSA or any of its staff members or any fellow student wilfully into disrepute, IPSA will have the right to cancel my student membership at IPSA.

3. Tuition fees

  • 3. 1 I/we, the undersigned, hereby assume absolute responsibility for the payment of any fees that may fall due as a result of my studies / studies of my/our child on the appointed due dates as determined by IPSA from time to time.
  • 3. 2 The terms of payment of the College for the current academic year is available on IPSA’s website, the IPSA intranet and the Student Handbook.
  • 3. 3 I confirm that, in the event of my failure to pay any amount due by or required of me on the due date, all outstanding fees owing to IPSA at that point shall become due and payable in one sum with immediate effect.
  • 3. 4 I agree that the nature and amount of my debt to IPSA shall at any time be proven by a written statement signed by or on behalf of the Principal of IPSA or his duly authorized representative whose authority need not be proved, acting reasonably and in good faith, and this certificate shall constitute as prima facie proof of the contents thereof and of the amount of my debt and the fact that such an amount is due and payable in legal proceedings against me.
  • 3. 5 In respect of students not fulfilling their financial obligations on time and as prescribed, the College retains the right:
  • a. To withhold the student’s examination results or certificates/degrees;
  • b. To cancel the student’s registration after the specified dates and to hold them/ the responsible party liable for payment of the outstanding amounts as agreed upon and signed in the special arrangement made with IPSA;
  • c. Not to allow students to register if the previous year’s fees have not been paid in full;
  • d. Not to issue a certificate of conduct; and
  • e. To institute legal action against the student/ the person liable for the payment of fees, who will be liable for all IPSA’s legal costs;
  • f. I am well informed that all of the above can be avoided if a written agreement is reached and signed with the finance officer upon the agreement and instruction of the principal of IPSA; and
  • g. I am well aware that it is my sole responsibility to inform the finance officer of any change in my economic status.

4. Period of study and Employment while Studying Full-Time

  • 4.1 The BA degree course may to be completed in a minimum of three (03) years. There is presently no maximum period.
  • 4.2 This applies to students who has registered as full-time students.
  • 4.3 The BA Degree course may be done part-time, as a day-time student over a minimum of 5 years. There is no maximum period at this stage.
  • 4.4 Full-time students must not be employed or so occupied with duties during their period of study at IPSA as to restrict their times, as to interfere with the credit hours of their modules of study.
  • 4.5 A student who must work during weekdays or weekends or who is so occupied with necessary duties of any kind, must be registered as a day part time student and must work out his/her subject load in conjunction with the Head of the Examinations & Records (ER) Office. Timetable problems may occur in this scenario. I am, herewith informed that adjustments to the time table will not be made to accommodate the student.
  • 4.6 Full- time students who are recipients of financial aid of any kind offered at or facilitated by IPSA must not be employed in any manner whatsoever and for any duration whatsoever during their period of study at IPSA.

5. Class Attendance

Students will be provided with a weekly time-table and calendar which must be followed. I, as student, am fully aware:

  • 5.1 That the IPSA time-table and or calendar may be subject to change as amended and instructed by the principal, deputy principal and/ or his/her duly authorized representative.
  • 5.2 That classes start at 08:15am and can run up until 4pm, depending on the subjects taught or assessments administered in my programme of choice.
  • 5.3 That I must be seated in my class 5min before it commences taking due care to have all my required material with me which includes having my prescribed books, Arabic dictionary and stationery with me daily.
  • 5.4 That I am required to attend all classes, including the ṣalᾱh period, of which a detailed register will be kept.
  • 5.5 That Salah al-Z̟uhr is an allocated period on the time- table and that it has to be attended by all students. Failure to do so will result in a default being recorded against my name, which may result in further action being taken against me and which include suspension or expulsion.
  • 5.6 That a 70% attendance for each module is required to qualify me for eligibility to write exams.
  • 5.7 That I must obtain a minimum 50% mark in my continuous assessments for any semester, failing which I will not be allowed to write the semester examinations in that specific module or modules.
  • 5.8 That I must make my own arrangements to retrieve lessons from my class-mates when absent, since no lectures will be repeated.
  • 5.9 That the class-tests may be written in the afternoon after Salah al-Z̟uhr. These written class-tests are compulsory for all students and I must therefore check my assessment schedule and make the necessary arrangements to attend these assessments.
  • 5.10 That I must provide a motivational letter from a parent (unmarried students), in the event that I am absent from a class, and a registered medical practitioner’s certificate when absent during any assessment or examination including the semester examinations.
  • 5.11 That in the event of my absence I will not be permitted to partake in any scheduled re- write/ missed exams if I fail to produce a registered medical practitioner’s certificate as validation for my absence.
  • 5.12 That IPSA reserves the right to accept or decline motivational/ explanation letters/ medical practitioner’s certificates based on merit and/ or verification of its merit.
  • 5.13 That I must collect a late slip at reception when I am late, before entering my class.

6. Residence in one of the student residences or housing units of IPSA

As a student resident I hereby undertake to:

  • 6.1 Duly complete and sign the application forms with regard to my year of entry and type of residence;
  • 6.2 Make myself familiar with all the rules, regulations, policies and procedures pertaining to residence or accommodation occupancy and to comply with these regulations and abide by these rules, policies and procedures;
  • 6.3 Take cognizance of the rules governing the following: temporary and/or part-time employment, the period of tenancy, damage to and restitutional damages in respect of student residences and lodgings, disturbance of the peace and that my contract can, when I am in breach hereof can be cancelled in respect of residence and that I can be evicted by the IPSA.

7. Amendment to this agreement

  • 7.1 I acknowledge that, unless expressly changed in writing, all the terms of this agreement shall remain in force and shall stand for as long as I am a registered student of IPSA, irrespective of whether or not my studies may be suspended.
  • 7.2 I declare that no amendment or change to this agreement, including this clause, shall be valid unless it has been duly authorised in writing by either the Principal, Deputy-Principal or his/her duly authorised representative.

8. Access to information

I accept, agree and understand that IPSA keeps and processes data and documents in electronic and paper format, including the data supplied by me during application and registration. IPSA may use and transfer such data and use such documents in electronic or other formats for IPSA purposes. This includes but is not limited to the following:

  • 8.1 IPSA may make use of my personal information (including my surname and first name, identity number, passport number, student number and face image, as well as my cell phone number) for academic, administrative purposes.
  • 8.2 Details relating to my academic performance may be used in the interest of my own academic development and support which includes communication with my parent/s, guardian and/or bursary sponsor.
  • 8.3 My name, address and phone number may be made available to the IPSA Alumni Office and to potential employers for a possible employment opportunity or to such other persons as may be indicated if IPSA is compelled by law to adhere to the request (e.g. national learner record database as required by the Department of Higher Education).
  • 8.4 Every signatory hereby authorises IPSA to collect all of the personal data supplied by them to IPSA respectively for research, statistical, credit control and publication purposes, to retain such data and to process the data for the aforementioned purposes of IPSA and to publish such data and make this data available to third parties. Without detracting from the generality of the foregoing, the applicant / student irrevocably authorises IPSA to account, communicate and report to the spouse, parents or legal guardian of the applicant /student and any person or body responsible for the payment of the tuition and other fees or who has awarded a bursary to the applicant /student to pay in part or in full for the studies and other expenses of the applicant /student regarding the academic and general progress of the applicant /student and in respect of any monies due to IPSA and to communicate to all of the aforesaid and any prospective employer all personal data required by such a third party. In general, each signatory agrees to the publication of personal information in any format to such third parties as IPSA may deem necessary or may be required to do in the conduct of its responsibilities. All signatories to this agreement agree and acknowledge that my/our consent is extended to IPSA to disseminate personal information when such is required.

9. General terms

I hereby:

  • 9.1 Declare that this agreement which has been completed and duly signed is applicable to my total period of study at IPSA;
  • 9.2 Declare that I have acquainted myself with, and in the future will keep myself acquainted with, the contents of the College’s Statute, policies, academic and financial rules and regulations pertaining to study at IPSA and published on the IPSA website: http://www.ipsa-edu.org and its intranet.
  • 9.3 Declare that, in the event of my being under-aged, this agreement is concluded with the consent and assistance of my parents and/or guardian;
  • 9.4 Declare that should it be deemed necessary by IPSA (as a result of this agreement) to institute legal proceedings against me, and should I be unsuccessful in such legal proceedings, I may be liable for the legal costs according to the attorney and own client scale of fees, if decided by the court;
  • 9.5 Accept the jurisdiction of the Athlone Magistrate’s Court, Western Cape in the event of any action or claim for damages being instituted or brought against me;
  • 9.6 Consent to an emolument attachment order if IPSA should succeed in any legal action to claim or recover any monies from me;
  • 9.7 Declare that IPSA has the right to move students to extended period of study for any programme if their academic performance is not adequate in the first semester of a specific academic year.
  • 9.8 Declare that in accordance with the rules, regulations, policies and procedures of IPSA, I will give a written application and wait for written notification of the ER Office of IPSA in the event that I should decide:
  • a. To change my course of study or curriculum;
  • b. To terminate my studies in part or in their entirety;
  • c. Not to pursue a particular programme of study in the second semester; or
  • d. And I accept that failure to do so will result in my being indebted in any amount of tuition fees that, owing to my omission, would have become payable to IPSA.

10. Physical address for official notices

  • 10.1 I/we, the undersigned, hereby appoint as our physical address for all purposes in terms of this agreement, including the service of legal process, the address set out below.
  • 10.2 I hereby elect, for the purpose of serving all process documents and any other notices pertaining to my studies or research at IPSA, the address entitled “Physical Address”, as stated on this agreement form.

11. Surety/ Parent/ Guardian/ Spouse

  • 11.1 Each signatory (hereinafter referred to as the “surety/ies”) to this agreement, other than the applicant/ student, hereby bind himself/ themselves as surety/ies and co-principal debtor/s jointly and severally for and with the applicant/ student (the principal debtor) in solidum in favour of IPSA for the payment of all debts and due fulfilment of all obligations of whatever nature and however arising which the applicant/ student may now or hereafter owe to IPSA (an application fee, for instance).
  • 11.2 Each Surety/ Parent/ Guardian/ Spouse that signs this agreement consents to the collection and processing of their personal information for the administrative purposes of the applicant to this agreement.

* Note: An applicant/student under the age of 18 must have this section signed by either of his/her parents. If an applicant /student has no parents (e.g. they are deceased) or the parents are divorced, a legal guardian is normally officially appointed if the person is a minor in law. In such cases, the legal guardian must sign this form. If you do not have a parent or a legal guardian, a responsible adult family member (next-of-kin) or other responsible adult who is prepared to make the declaration and the undertaking must sign with you. The details of the parent/legal guardian must be listed on this form.

B. INDEMNITY AND UNDERTAKING

12. Exemption and indemnity

Applicants/students under the age of 18 years old must be assisted by either both their parents or one parent in the case of one being deceased or in the case of divorced parents or guardian. (This must be the same person listed as next-of-kin.)

  • 12.1 I, the applicant/student and (where applicable) I, the parent/guardian/next-of-kin/spouse of the applicant/student, declare and agree as follows:
  • 12.2 I understand and acknowledge that with the view to keeping fees affordable, there is no obligation on the International Peace College South Africa (“the College”) to take out insurance to cover risks to which applicants/students are exposed while studying at the College.
  • 12.3 Each signatory of this exemption and indemnity waives all rights that he/she may have or may acquire to claim compensation for loss or damage arising from the conduct of the College or someone for whose conduct the College is responsible.
  • 12.4 Each signatory of this exemption and indemnity furthermore assumes the obligation of the College or person for whose conduct the College is responsible in respect of such a liability.
  • 12.5 I understand that for purposes of the exemption and indemnity, the expression “conduct” includes omissions.
  • 12.6 The exemption and indemnity will not apply where the liability of the College or person for whose conduct the College is responsible is covered by insurance or a statutory compensation scheme (for example the third party compensation scheme relating to motor vehicle accidents). It will also not apply if the loss or damage arising from the gross negligence of the College or a person acting on behalf of the College.