UCT FHS Registration: Clinical Coding Courses

REGISTRATION FORM

UCT FHS Clinical Coding Short Courses & Workshops
Please note that if you have been academically excluded from UCT, or have current unpaid fees still owing to the university, you will not be allowed to register for this short course.

For live lecture sessions, please view available dates here: View available dates here: https://health.uct.ac.za/continuing-education-unit/2025-courses
Course Name*
I wish to complete the course by attending the live online lectures on the date specified below (see date field at the bottom of this page).I wish to complete the course via distance learning (please enter "distance learning" in the date field below).
Enter your selected course date here (dd/mm/yyyy) OR distance learning*
NOTE: Please check the training schedule via the link above for available online session dates. If you have opted for distance learning, please enter Distance Learning here.

Contact Details
Email*
example@example.com
Cell Phone Number*
Address
Postal Code
Country

Miscellaneous
YesNo
If yes, please specify:
YesNo

Payment Information
My employer/company is paying - the payment link will be sent to you once you have received confirmation of placement on the course.I am paying for myself - the payment link will be sent to you once you have received confirmation of placement on the course.
Name of Company
Postal Address
Postal Code
Street Address
Postal Code
VAT registration number
Purchase Order Number (if applicable)
Business Sector (e.g. Commercial, Government, NPO)
Industry Type (e.g. Finance, Electronics, Education)
Contact person (e.g. Finance officer) to whom the invoice should be emailed
Name
Position
Email
example@example.com
Telephone

Terms & Conditions
1. We will acknowledge receipt of your registration form. If there are no available spaces, you will be notified.

2. Closing date for registrations is dependent on the particulars of each course. You may not cancel your registration after registrations have closed.

3. Fees are due two weeks before the start of the course, unless otherwise arranged with the Continuing Education Unit.

4. We must be informed of cancellations in writing at least one week before the start of the course or the full fee will be charged.

5. Where cancellations are received after the course material has been sent to the delegate, a cancellation fee of 25% of the total course fee will be charged.

6. UCT reserves the right to take any legal proceedings to recover the full fees payable, and to recover the costs in connection with such recovery.

7. Certificates will be issued in the name supplied on your ID. No certificate will be issued until full payment of the course fee has been received.

8. Certificates are issued in digital format only. The link to access this document will be emailed to the address specified on this form.

9. Certificates will not be issued to any student who is not in financial good standing with UCT.

10. UCT reserves the right to cancel any registration or revoke certification should the student have any tertiary education disciplinary measures against their name.

11. UCT reserves the right to cancel the course if insufficient registrations are received, in which case, the course fee will be refunded in full if already paid.

I have read and accept these terms and conditions.
Signature*

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Date*
DD/MM/YYYY
Should be Empty:

REGISTRATION FORM

Personal Details

Contact Details

Miscellaneous

Payment Information

Terms & Conditions