UCT FHS Registration: Basic Counselling Skills

REGISTRATION FORM

UCT FHS Short Courses & Workshops
Please note that if you have been academically excluded from UCT, or not in financial goodstanding with UCT, you will not be allowed to register for this short course.

UCT reserves the right to postpone the course if the minimum number of registrations are not met. Your registration and payment will be automatically moved to the next scheduled course date.
Course Name*
Course Date*
Please select the date you wish to attend.

Personal Details
Title (e.g.: Dr / Mr / Mrs / Miss)
Name*

First NamesSurname
Student Number (if previously registered with UCT)
ID Number / Passport Number*
Please upload a copy of your ID*

Your name as it appears on your ID will be printed to your certificate.
Cancelof
Date of Birth*
DD/MM/YYYY
Nationality*
Highest Qualification
HPCSA / SANC Number
If applicable
Occupation
Company / Employer

Contact Information
Email (your digital certificate will be emailed to this address)*
Please use this address to access to your digital certificate.
Mobile Number
Address
Country
Postal Code

Miscellaneous
Dietary Requirements (NB: Applicable to in-person courses only)
For allergies, please provide more information here
Do you have any other special requirements that we should be made aware of?

YesNo
If yes, please provide more information here

Payment Information
Who is paying for you to attend this course?*
The link for payment of the course fee will be emailed to you once your registration has been confirmed. Kindly ensure that payment is made at least two weeks before the start date.

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 immediately upon registration, unless otherwise arranged with the Continuing Education Unit.

4. We must be informed of cancellations in writing at least two weeks 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, the full 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 are issued in digital format only. The link to access this document will be sent to the email address provided on this registration form. No certificate will be issued until full payment of the course fee has been received.

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

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

10. 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*

Clear
Date*
DD/MM/YYYY
Should be Empty:

REGISTRATION FORM

Personal Details

Contact Information

The following information is required for UCT reporting purposes only

Miscellaneous

Payment Information

Terms & Conditions