Eth.BE - COURSE APPLICATION FORM

COURSE REGISTRATION FORM
Please Select A Course You Wish To Enroll:
Course Commencement Date:

DayMonthYear
Date
APPLICANT INFORMATION
Salutation:
Name In Full (As per NRIC/Passport)

First NameLast Name
NRIC/FIN/Passport Number:
Nationality:
Age:
Date of Birth:

DayMonthYear
Date
Gender:
Mobile Phone:

Country CodePhone Number
Highest Qualification:
Email:
example@example.com
Mailing Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Are you currently residing in Singapore?
This section is ONLY for Company Sponsored Applicant. You may leave it blank if it is not applicable.
Company Registration Name:
Company UEN Number:
Sponsors/Employer Name:
Correspondence Email:
Correspondence Phone:

Country CodePhone Number
Billing Address if it is different from the above mentioned:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
OTHER DETAILS & DECLARATION
If you have any disabilities, illness, medical conditions etc. that can affect your virtual classes/study, please specific?
For Governance, Risk, Anti-Money Laundering, Compliance & Ethics courses, if you have a MAS license, please specific what type of license are you holding?
For Legal Practitioner with SILE CPD Requirement, please provide your AAS/ S36B FL Number (only for Singapore Practitioners)
Have you been given funding before for the course you are applying for?
How did you learn about RHT Academy course (Powered by VRSE)?

Other
Would you like to receive marketing and promotional materials from us and our affiliates or related entities?
If Yes, please select (one or more) your preferred mode of contact:
Terms and Conditions:

1) The course schedule selected is subject to confirmation. RHT Academy reserves the rights to withdraw or re-schedule the class without prior notice.

2) I affirm that all information given in this registration form is true and accurate, and I have not deliberately omitted any relevant fact. I understand any false or misleading declaration shall make me liable for disqualification, or if already admitted, for expulsion from the course without any refund of fees paid.

3) The application form and full course fee payment must be submitted to RHT Academy, to sales personnel at least 7 working days before course commencement.
Name of Sales/Admissions Channel:
Signature of Applicant:
Date Signed:

DayMonthYear
Date
Should be Empty:

COURSE REGISTRATION FORM

APPLICANT INFORMATION

OTHER DETAILS & DECLARATION