Mixed-Media Mash-up
Please fill the form below correctly
Name
*
First Name
Last Name
Date of Birth
*
Please select a day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Day
Please select a month
January
February
March
April
May
June
July
August
September
October
November
December
Month
Please select a year
2014
2013
2012
2011
2010
2009
Year
Age
*
Gender
*
Male
Female
Nationality
*
Contact Details
Phone
*
Mobile
Email
*
example@example.com
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Parent/Guardian Details (if applicant is under 18)
This for students who are under 18.
Parent / Guardian Name
*
Prefix
First Name
Last Name
Relationship
*
Phone
*
Mobile
Email
example@example.com
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Next
Supporting Documents
Certified copy of child's I.D.
Upload a File
Drag and drop files here
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of
Kindly note this is a 3-day workshop- students are required to attend all dates to receive their certificate of completion.
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