Student Registration Form
Fill out the form carefully for registration
Student Name
First Name
Middle Name
Last Name
Birth Date
January
February
March
April
May
June
July
August
September
October
November
December
Month
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
Year
Gender
Please Select
Male
Female
N/A
Student E-mail
example@example.com
Mobile Number
Additional Comments
My Products
prev
next
( X )
Deposit On Line Mentorship 2021/22
Please complete the form or email your experience so I know which group to add you too. Deposits are non refundable
£
150.00
Balance On Line Mentorship
Balance Payment is due on 1st November 2021 If you cannot pay in full please visit the website www.tjhiggs.com and use the payl8r service. This is an affordable way of paying your balance.
£
300.00
On Line Mentorship
Please complete the form and if you are new to TJ please use the comments section to let us know your development so far.
£
450.00
Balance Payment
Please use this to pay off the monthly balance if you cannot do it all at once.
£
100.00
Submit Application
Payment Methods
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Please click one of the PayPal options to complete payment and
submit
the form.
Should be Empty: