ASTC - Online Registration Form

Invoice No:
Student No:
Consultant:
Method of Payment:*

CardDepositEFT
Starting Date:*

DayMonthYear
Select starting date
Student Information
First Names:*
Surname:*
ID Number:*
Home Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Home Telephone:
Work Telephone:
Mobile Number:*
Email Address:*
Social Media (Optional)
Facebook:
Instagram:
Twitter:
Standard of Education:*
Spouse or Family Member
First Names*
Surname*
Home Telephone:
Work Telephone:
Mobile Number:*
Company Information
Approved by:
Initials and Surname
Position:
Email Address:
Company Name:
Company Registration No.:
Company VAT No.:
Postal Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Physical Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Company Office Phone Number:
Company Office Fax Number:
Company Mobile Number:
- Students are expected to attend a minimum of 70% of the classes otherwise they will be asked to repeat the course at their own cost.
- If the company is paying for the course, the HR Dept or Manager in charge of the student will be notiﬁed accordingly.
THOSE LEARNERS ENROLLED FOR 15 DAYS + COURSES WILL RECEIVE:
- Overall + T shirt
- Safety Shoes
- All Course Materials and Stationary where Applicable
THOSE LEARNERS ENROLLED FOR BASIC COURSES:
(1 Day and 3 Days Courses)
- Must Provide Own PPE
- All course materials and stationary where applicable will be provided
Training will be conducted at own risk

Under no circumstances will courses be changed after commencement.

EASTC reserves the right to use any information, photographs and/or videos of any student enrolled as such by it, at any time taken/shot at any of its centres or those of its facilitators, and/or event sponsored by it, without the express written consent of such student. EASTC may use such information, photographs and/ or videos in publications or other media material produced, used or contracted by EASTC including but not limited to brochures, books, invitations, magazines as well as television advertisements.
I have read and understand the above terms and conditions and will adhere to them.*

YesNo
I (Student Name)*
And we
The sponsoring Company (Where applicable)
Hereby agree to be jointly and severally liable for the total fee.

I/We further agree that failure to attend lectures will not deduct
my/our responsibility for the fees for the full course.

Cancellations within 10 working days prior to course commencement date will incur a cancellation fee to the value of 50% of course fee.
I agree*

Yes
COMPLETE IF COMPANY APPROVED
Approved by:
Initials and Surname
Position:
Invoice for the attention of:
Upload copy of ID*

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Upload proof of payment

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