ASTC - Online Registration Form

Invoice No:

Student No:

Consultant:

Method of Payment: *

Card Deposit EFT

Starting Date: *

Select starting date

Student Information

First Names: *

Surname: *

ID Number: *

Home Address: *

Street Address

Street Address Line 2

City

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

City

Postal / Zip Code

Physical Address:

Street Address

Street Address Line 2

City

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. *

Yes No

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 *

Upload copy of ID

Upload proof of payment