Registration Form - IMP18/17

 
Last Contacted

Invalid Input

Reg Status
Invalid Input

RP
Invalid Input

ID
Invalid Input

DO
Invalid Input

MC
Invalid Input

CP
Invalid Input

TS
Invalid Input

PT
Invalid Input

MA
Invalid Input

INV
Invalid Input

Notes
Invalid Input

STUDENT DETAILS


Intake*
Invalid Input


Name & Surname*
Invalid Input

Nic Name / Pseudonym
Invalid Input

ID / Passport Nr*
Invalid Input

Cell Number*
Invalid Input

Email Address*
Invalid Email address or does not exist

PHYSICAL ADDRESS

Nationality*
Invalid Input

Street / Block*
Invalid Input

Suburb / Area*
Invalid Input

City / Town*
Invalid Input

Province / State*
Invalid Input

Province*
Invalid Input = Please select a province

Area / Zip Code*
Invalid Input

POSTAL ADDRESS

Same As Physical Address*
Invalid Input

P.O. Box*
Invalid Input

Suburb / Area*
Invalid Input

City / Town*
Invalid Input

Country*
Invalid Input

Postal / Zip Code*
Invalid Input

 

NEXT OF KIN


Name & Surname*
Invalid Input

Select Relationship*
Invalid Input

Cellphone Number*
Invalid Input

Email Address*
Invalid Email Address

 

PAYEE DETAILS


Who's the Payee?*
Invalid Input - Please make a selection

Name & Surname*
Invalid Input

Cellphone Number*
Invalid Input

Email Address
Invalid Email Address

PHYSICAL ADDRESS

Street / Block*
Invalid Input

Suburb / Area*
Invalid Input

City / Town*
Invalid Input

Province / State*
Invalid Input

Country*
Invalid Input

Area / Zip Code*
Invalid Input

POSTAL ADDRESS

Same As Physical Address*
Invalid Input

P.O. Box*
Invalid Input

Suburb / Area*
Invalid Input

City / Town*
Invalid Input

Postal / Zip Code*
Invalid Input

Country*
Invalid Input

As student you are responsible for the payment of your course fees.

Please continue with the registration and select your payment option.

 

COURSE PAYMENT DETAILS


NOTE: International Students needs to settle the full course cost before the course starting date or the course discounted date as advertised - however you can distribute the cost of the course by starting to make payments contributions towards the course in advance.

Payment Option*
Invalid Input - Please make a selection

NOTE: Once-Off Discounted Course Cost needs to be paid in Full before the discount cut-off date.

As Payee you can start making payments towards the course in advance and still get the discounted course rate if it paid in full before the deadline date.

NOTE: If you are applying for a loan or bursary you will need to have the loan secured before the starting date of the course or you may forfeit your place.

Please contact our institution immediately after submitting this form so we can provide you with the necessary documentation needed for your loan or bursary application to speed up the process.

NOTE: Monthly Payment Options Are Strictly done by Debit Order.

Please download the Debit Oder Form below and submit with this application.

 

STATISTICAL DETAILS


Home Language*
Invalid Input

Any Disabilities*
Invalid Input

Specify Disablities*
Invalid Input

Any Special Needs?*
Invalid Input

Specify Needs*
Invalid Input

Higest Qualification*
Invalid Input - Please make a selection

Gender*
Invalid Input

Age Group*
Invalid Input

Specify Race*
Invalid Input

T-Shirt Size*
Invalid Input

Do you play any Instruments?*
Invalid Input

List Instruments*
Invalid Input

Do you own a Computer?*
Invalid Input

Operating System?*
Invalid Input

Favorite Music Genre(s)*
Invalid Input

Where did you here about us?*
Invalid Input

Specify Other*
Invalid Input

 

TERMS & CONDITIONS


Terms & Conditions*
Invalid Input

*
Please tic the selection box

Any Notes
Invalid Input

Draw your signature using your mouse or finger.*
Invalid Input

STUDENT DETAILS
Invalid Input

NEXT OF KIN
Invalid Input

STATISTICAL
Invalid Input

PAYMENT DETAILS
Invalid Input

PAYEE DETAILS
Invalid Input