P
lease refer to the booklet for information regarding the
following printable documents.
Included:
- Sentevorm
Metanoia’s MAD2 Fundraising Initiative. Please fill it out
and bring it on move-in day, we will be collecting them.
Please note that each block represents a separate
amount. R10 is not the final amount that must be
collected.
- Debit Form
For those wishing to donate to the Meta4Meta
foundation. Please see the welcoming booklet for more
information.
- Meta4Meta Application Form
If you are in any financial support, please complete the
Meta4Meta application form. Please see the booklet for
more information.
Maak ’n skenking
(see reverse side for English)
META4META
TITEL
VOORLETTERS
POSADRES
VAN
NOOIENSVAN
TELEFOON (HUIS)
GEBOORTEDATUM
TELEFOON (KANTOOR)
STUDENTE- OF ID-NOMMER
E-POS ADRES
(u studentenommer is op US-posstukke aan u)
BANKDEBIETORDER
bank
dorp/stad
tak
takkode
rekeningnommer
Ter bevordering van die Universiteit Stellenbosch skenk ek, die ondergetekende, hiermee aan die Universiteit die volgende:
(Merk asseblief u keuse of skryf u gekose bedrag in.)
my bydrae
R50
frekwensie
maandeliks
tydperk
1 jaar
R100
2 jaar
R250
R1000
ander bedrag
kwartaalliks
halfjaarliks
3 jaar
5 jaar
4 jaar
jaarliks
totdat ek hierdie opdrag skriftelik wysig
datum van eerste betaling
EENMALIGE BYDRAE
Tjek betaalbaar aan die Universiteit Stellenbosch, hierby ingesluit
Die bedrag van my bydrae is
BYDRAE PER KREDIETKAART
kredietkaartrekeningnommer
vervaldatum
kaarttipe
laaste 3 nrs. agter op kaart
Ek besef dat my keuse om my kredietkaart as betaalmetode te gebruik op eie risiko is. Ek aanvaar dat die Universiteit Stellenbosch (US) alle redelike stappe
sal doen om te verseker dat die inligting wat ek op hierdie vorm verstrek vertroulik gehou word, maar dat die US, sy werknemers of agente geensins
aanspreeklik sal wees vir enige moontlike verlies of skade wat ek as gevolg van my keuse van hierdie betaalmetode ly nie. Ek onderneem dus om nie die US
vir enige verlies of skade aanspreeklik te hou nie, buiten waar sodanige verlies of skade veroorsaak is deur, of die gevolg is van, bedrog deur ’n werknemer of
agent van die Universiteit.
ELEKTRONIESE OORBETALINGS
RSA: Universiteit Stellenbosch
BANK: Standard Bank
TAK: Stellenbosch
TAKKODE: 05 06 10
REKENINGNAAM: Universiteit Stellenbosch
REKENINGNOMMER: 073006955 (gebonde skenkings)
073002437 (ongebonde skenkings)
VERWYSING: HK410 Naam Van
VK: Stellenbosch University SA Foundation UK
BANK: First National Bank Cape Town
BANK ADRES: 5th Floor Media City, No 1 Heerengracht,
Rua Vasco Da Gama Entrance, Foreshore, Cape Town
REKENINGNAAM: University of Stellenbosch – Foreign Income
REKENINGNOMMER: 621 0717 7083 TAKKODE: 204 109
S.W.I.F.T Adres:FIRNZAJJ VERWYSING:
E-pos of faks afskrif van hierdie vorm aan:
Mnr William Frankel: [email protected]
Aandag alle VSA skenkers: Kontak asb. vir Joan Weyers ([email protected])
voor u ’n skenking maak
VSA: Friends of the University of Stellenbosch Foundation
BANK: First National Bank Cape Town
BANK ADRES: 5th Floor Media City, No 1 Heerengracht,
Rua Vasco Da Gama Entrance, Foreshore, Cape Town
REKENINGNAAM: University of Stellenbosch – Foreign Income
REKENINGNOMMER: 621 0717 7083 BRANCH CODE: 204 109
S.W.I.F.T Adres:FIRNZAJJ VERWYSING:
E-pos of faks afskrif van hierdie vorm aan:
Me Joan Weyers: [email protected], faks RSA +27 86 569 5372
RES VAN DIE WêRELD:
BANK: First National Bank Cape Town
BANK ADRES: 5th Floor Media City, No 1 Heerengracht,
Rua Vasco Da Gama Entrance, Foreshore, Cape Town
REKENINGNAAM: University of Stellenbosch – Foreign Income
REKENINGNOMMER: 621 0717 7083 TAKKODE: 204 109
S.W.I.F.T Adres:FIRNZAJJ VERWYSING:
ERFLATING
Ek wil graag meer inligting oor ‘n erflating aan die Universiteit Stellenbosch hê.
Die US is reeds ‘n begunstigde in my testament en ek wil graag ‘n lid word van die Erflatersgilde.
HANDTEKENING
DATUM
Ek/ons erken dat die party wat hiermee gemagtig is om die trekking(s) teenoor my / ons rekening te behartig, geen van sy / hulle regte aan ’n derde party
mag afstaan of sedeer sonder ons skriftelike toestemming wat vooraf verkry is nie, en dat ek / ons nie verpligtinge ingevolge hierdie kontrak / magtiging aan
’n derde party mag delegeer sonder skriftelike toestemming wat vooraf van die gemagtigde party verkry is nie.
Voltooi asseblief die vorm en pos, e-pos of faks terug aan die Universiteit vir naslaandoeleindes:
Ontwikkeling & Alumni-verhoudinge, Privaat Sak X1, Matieland 7602 - Faks: 086 569 5372 - E-pos: [email protected]
Make a gift
(sien keersy vir Afrikaans)
META4META
TITLE
INITIALS
POSTAL ADDRESS
SURNAME
MAIDEN NAME
TELEPHONE (HOME)
DATE OF BIRTH
TELEPHONE (OFFICE)
STUDENT- OR ID-NUMBER
E-MAIL ADDRESS
(your student number appears on your SU-mail)
BANK DEBIT ORDER
bank
town/city
branch
branch code
account number
To promote Stellenbosch University, I the undersigned, hereby donate the following amount to the University:
(please indicate the amount you prefer to donate)
my contribution
R50
frequency
monthly
period
1 year
R100
R250
R1000
quarterly
2 year
3 year
other amount
half-yearly
4 year
5 year
annually
until my notification to alter in writing
date of first deposit
SINGLE CONTRIBUTION
Cheque payable to Stellenbosch University, included herewith
The amount of my contribution is
DONATION PER CREDIT CARD
credit card number
expiry date
type of card
last 3 nos. on reverse side of card
I agree that my choice to use my credit card as per payment method is at my own risk. I accept that Stellenbosch University will take all reasonable steps to
ensure that the information provided in this form remains confidential but that Stellenbosch University, its employees or agents will not be liable in any manner
whatsoever for any loss or damage I may suffer as a result of using this payment method. I undertake not to hold Stellenbosch University liable for any loss or
damage except in the event of such loss or damage being caused by or is a result of fraud on the part of an employee or agent of Stellenbosch University.
ELECTRONIC TRANSFERS
RSA: Stellenbosch University
BANK: Standard Bank
BRANCH: Stellenbosch
BRANCH CODE: 05 06 10
ACCOUNT NAME: Stellenbosch University
ACCOUNT NUMBER: 073006955 (conditional gifts)
073002437 (unconditional gifts)
REFERENCE: HK410 Name Surname
UK: Stellenbosch University SA Foundation UK
BANK: First National Bank Cape Town
BANK ADDRESS: 5th Floor Media City, No 1 Heerengracht,
Rua Vasco Da Gama Entrance, Foreshore, Cape Town
ACCOUNT NAME: University of Stellenbosch – Foreign Income
ACCOUNT NUMBER: 621 0717 7083 BRANCH CODE: 204 109
S.W.I.F.T Address: FIRNZAJJ REFERENCE:
E-mail or fax a copy of this form to:
Mr William Frankel: [email protected]
Attention all USA Donors: Before making a deposit, please contact Joan
Weyers: [email protected]
USA: Friends of the University of Stellenbosch Foundation
BANK: First National Bank Cape Town
BANK ADDRESS: 5th Floor Media City, No 1 Heerengracht,
Rua Vasco Da Gama Entrance, Foreshore, Cape Town
ACCOUNT NAME: University of Stellenbosch – Foreign Income
ACCOUNT NUMBER: 621 0717 7083 BRANCH CODE: 204 109
S.W.I.F.T Address: FIRNZAJJ REFERENCE:
E-mail or fax a copy of this form to:
Mrs Joan Weyers: [email protected], fax RSA +27 86 569 5372
REST OF THE WORLD:
BANK: First National Bank Cape Town
BANK ADDRESS: 5th Floor Media City, No 1 Heerengracht,
Rua Vasco Da Gama Entrance, Foreshore, Cape Town
ACCOUNT NAME: University of Stellenbosch – Foreign Income
ACCOUNT NUMBER: 621 0717 7083 BRANCH CODE: 204 109
S.W.I.F.T Address: FIRNZAJJ REFERENCE:
GIFT IN MY WILL
I would like to receive information regarding a gift in my Will to Stellenbosch University.
I have already included the university in my Will and wish to be included in the Heritage Guild.
SIGNATURE
DATE
I / we acknowledge that the party hereby authorised to effect the drawing(s) against my / our account may not cede or assign any of its rights to any party
without my / our prior consent and that I / we may not delegate any of our obligations in terms of this contract / authority to any party without prior
written consent of the authorised party.
Please complete and post, email or fax the form to Stellenbosch University for reference purposes:
Development & Alumni Relations, Private Bag X1, Matieland 7602 – Fax: 086 569 5372 - Email: [email protected]
Meta4Meta
Application form
Personalia
Name and Surname
Student number
Room number
Course
Year of Study
Tick off all categories of assistance
Category 1
(x)
Tuition
Books
Food
Accommodation
Transport
Category 2
(x)
Toiletries
Basic Clothing
Bedding
Other
Category 1 areas: Submit the following together with your application
● Motivation for why you need assistance in that area
● A short concise CV (include academic record)
● Two testimonials from references that authoritatively provide evidence that you meet the
criteria for this award
Category 2 areas: Submit the following together with your application
● Brief summary of your situation and the area of assistance
Terms and conditions:
1. The Meta4Meta committee can exercise its discretion with regard to whom it awards
assistance.
2. Only committee members of Meta4Meta will have access to applications and supplementary
documents accompanying it. The information contained therein will not be disclosed to any
outside party.
3. Taking a means test and sitting for an interview are prerequisites to a successful application,
should you be shortlisted.
Signature:______________________ Date:_________________
Contact Information:
Email: [email protected]
House Committee Member:
Mac-Ray Mouton