QPS Parents or Gurdian Fees arrangement Form CONTACT US I the undersigned, Name(Required) First Last I.D. Number(Required) hereinafter referred to as the DEBTOR) the parent/guardian of Name(Required) Grade(Required)Grade RRGrade RGrade 1Grade 2Grade 3Grade 4Grade 5Grade 6Grade 7Grade 8Grade 9Grade 10Grade 11Grade 12do hereby acknowledge that I am legally indebted to the Queens Park Schools (hereinafter referred to as the CREDITOR) in the total sum amount ofNumber(Required)as atDate(Required) MM slash DD slash YYYY in respect of the outstanding school fees. I undertake to repay the said amount in the following instalment plan until the outstanding school fees is fully cleared: Payment PlanAgreed AmountPayment DateFirst Installment (Required)date(Required) MM slash DD slash YYYY Second Installment (Required)date(Required) MM slash DD slash YYYY Third Installment (Required)date(Required) MM slash DD slash YYYY I further acknowledge that the arrangement to pay the above-mentioned amount only serves to facilitate my commitment to settle the outstanding debt within the prescribed period set. This does not guarantee the release of results, transfer letters or confirmation of my child’s space in the upcoming school year unless the account is paid in full. I agree that should I, for any reason whatsoever, default to pay off with instalments or settle the outstanding debt as set out herein, the school shall have the right to make this agreement an order of the court without having to notify me first. I comprehend fully that any agreed payment dates are aligned to my salary date. I acknowledge that no indulgence or extension of time afforded to me can be regarded as a novation of my liability in terms of this acknowledgement of Debt. I confirm that the following are my particulars Home Address(Required) Street Address City ZIP / Postal Code Email(Required) Cell Number(Required)Other Cell Number(Required)Home Telephone Number(Required)Work Address(Required) Street Address City ZIP / Postal Code Work Email(Required) Work Telephone Number(Required)AttachmentsAffidavitMax. file size: 256 MB.3 months Bank statementMax. file size: 256 MB.3 month PayslipMax. file size: 256 MB.DeclarationDeclaration(Required) By ticking this box, I acknowledge the above to be true and accurate.(Required)I hereby declare that to the best of my knowledge, the above information as supplied is accurate and correct and I can be held legally accountable for un incorrect informationDate(Required) MM slash DD slash YYYY
