Student Registration Form
32 Grosvenor Avenue, Avondale, Atlantis, Cape Town, South Africa
Please select Course.
*
Please Select
Advanced Microsoft Office & AI Bundle course =R3200
Website Design Course = R3500
Course Method
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One to One Classes
Live Online Classes
Student Information
Student Name
*
First Name
Last Name
Date of Birth
*
-
Day
-
Month
Year
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Gender
*
Male
Female
Phone Number
*
Format: (000) 000-0000.
Email Address
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Do you have access to a Computer / Laptop?
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Yes
No
Do you have internet Access to do online classes?
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Yes
No
When can you start your Classes?
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Day
-
Month
Year
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What is the best time to do classes?
from 8h15am - 9h15am
from 9h30am - 10h30am
from 11h00am - 12h00pm
from 12h15pm -13h15pm
What is the best time to do classes?
from 14h15pm -15h15pm
from 15h30pm -16h30pm
from 17h00pm -18h00pm
will arrange flexible timeslots with instructor
Please Select any of the following: I am...
*
Employed
Unemployed
Self Employed
Student
Business Owner
Parent/Guardian Details
(Complete If under 18)
Your Parent/Guardian Name
First Name
Last Name
Parent Phone Number
Format: (000) 000-0000.
Parent Email
example@example.com
Others
How did you learn about this course?
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Facebook
Twitter
Instagram
YouTube
Google Search
Online Ads
Referred by Someone
Other
How will you make payment?
*
Please Select
EFT (only)
Please note Payment is Required before start of first Lesson. As Soon as you make payment and has cleared with our Bank, we can guarantee your selected course timeslots. (Kindly select Immediate payment if your bank is not Capitec Bank.
Do you have any other comments or question?
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