AI Literacy and Upskilling Registration Form

JA Services Limited
Capital Business Centre,
Entrance A, Floor 1,
Triq Taz Zwejt,
San Gwann, SGN3000,
Malta
VAT no. MT27023221
REGISTRATION FORM
Name*
Surname*
ID Card Number*
Date of Birth*

DayMonthYear
Date
House Name / Number*
Street Name*
Location*
Telephone Number
Mobile Number*
Email Address*
example@example.com
Module Booked*
Course Fee (€)*
Payment Method*
Account name: JA Services Limited
Bank Name: Revolut
IBAN: LT833250059358437953
BIC: REVOLT21

or

Revolut Pay
I confirm that I have read and accepted the Terms and ConditionsI confirm that I have read the Privacy Policy
Student Signature

Clear
Should be Empty: