Training Registration From
Please fill in the form below to enroll in one of our classes.
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Full Name
*
First Name
Last Name
Preferred Name for Certificate
Phone Number
*
-
Area Code
Phone Number
Mobile Number
*
-
E-mail
*
Select your Course
*
Please Select
Course 1 For the duration of _______
Course 2: For the duration of _______
Course 3: For the duration of _______
Today's Date
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Month
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Day
Year
Date
Country
Town or City
Your Occupation
Why do you want to participate in this training?
Any prior training in fish farming?
Yes
No
Any prior health conditions we should be aware off? If yes please speak with us
Yes
No
Please list special requirements or needs if any: E.g ( Physical disability etc)
Please provide the name and (preferably mobile) number of a person to contact in case of an emergency:
*
I give permission for my contact details (email and/or phone no) to be shared with my classmates at the end of class
*
Yes
No
I have completed pre-requisite classes (if any), in fish farming
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Yes
No
Which method of payment will you be using?
*
Credit Card
Online Transfer
Request a receipt
Please send me a receipt
Please choose which applies to you.
*
I am paying in full by Credit Card - I will call with my details
Online Transfer - I am depositing the full amount
Online Transfer - Part-Payment Deposit & the remainder no later than 2 weeks prior to class
Do you agree to the Terms & Conditions?
*
Yes, I have read and I agree.
Click
HERE
for our Terms & Conditions
Any special Notes to us? Please state:
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