CBSS Course Registration Form

CBSS Training Course Registration Form
I would like to attend the following Training Course:
Please select the Training Course you wish to attend:*
PLEASE NOTE THAT WE DO NOT PRESENT ALL TRAINING COURSES ON A SCHEDULED BASIS - IF THE COURSE YOU ARE INTERESTED IN DOES NOT APPEAR ON THIS LIST, KINDLY SEND US A MESSAGE ON OUR CONTACT PAGE.
Person attending the Training Course

(please complete a separate form for each course attendee)
Full Name of person attending the Course*

First NameLast Name
Nationality*
E-mail*

Confirmation Emailexample@example.com
ID No. (S.A. Citizens) / Passport No. (Non-SA citizens)*
Cell number*
Dietary Needs/ Food Allergies
Please specify Vegetarian/Halaal/etc., as well as any food allergies
Work Phone*

Area CodeNumber

Course Payment Options

Please read the Ts & Cs on our website
Who will pay for the course?*
How would you like to pay for the course?*
Pay now with PayFast

prevnext( X )
ZARTotal Course Cost (incl VAT)
If you select to pay with PayFast, but you have not been succesful, please submit your form indicating payment with an Invoice, and email us (training@cbss.co.za) requesting the link to the secure payment portal on Payfast
Company responsible for payment*
Name of company responsible for payment
My Company is registered for VAT

YesNo
Company VAT Number
If Company is VAT Registered, please add VAT number
Full Name of person responsible for payment*

TitleFirst NameLast Name
Position in Company of person responsible for payment *
Position of person responsible for payment
E-mail of person responsible for payment*

Confirmation Emailexample@example.com
Work Phone of person responsible for payment *

Area CodeNumber
Physical Address for Invoice*

Street Address

Street Address Line 2

CityProvince

Postal CodeCountry
Postal Address for Invoice*

Postal Address

Street Address Line 2

CityProvince

Postal CodeCountry

Agreement
By clicking the checkbox below, I confirm my attendance at the Training Course, and I confirm that my details indicated above are correct.

I agree to the CBSS payment procedures, and understand that I will be liable for the Full Course cost, as well as penalty costs, where applicable. Where my course fees are to be settled by my employer, I confirm that I will make the necessary arrangements to facilitate payment, and understand that such arrangement does not absolve me from my liabilities and obligations in this matter.

I understand that all outstanding accounts will be handed over to attorneys, and by accepting this agreement and signing it, I undertake to pay all the legal costs on the Attorney and own Client scale, including collection commission and tracing fees, incurred by the Creditor if securing compliance with the provisions of this Agreement is needed.

I also understand that the personal information that I have provided will not be made available to anyone unless legally required, and will only be used to process my attendace of, and payment for the course. I acknowledge that photos taken during the course may be used for marketing purposes.

By submitting this Form to us, either directly, or by email or fax, I confirm all the above, as if I have signed the form in person.
Signature (please sign the form using your mouse or finger)*

Clear
Next steps:
- Double-check your answers to make sure your details are correct.
- If you are responsible for payment, submit the form right away, by clicking on the "SUBMIT FORM" button. We will then issue you with an invoice, which is payable upon receipt. If you have indicated that you will pay with PayFast, and were unsuccesful with the Gateway, please let us know, so that we can email you a link to the secure payment gateway.
- If you have to obtain your employers' permission to attend the Course, or if you need a Quotation, click the "PRINT FORM" button after previewing your answers. Once you have obtained the necessary approval from your employer, please scan the printed form and email (training@cbss.co.za) or fax (086 693 5189) it to us to ensure your registration for the Course.
Date*

YearMonthDay
Date
If you experience any dificulty with submitting the form online, please click on the "PRINT FORM" button, print to PDF, and email it to training@cbss.co.za.
Should be Empty:

CBSS Training Course Registration Form

I would like to attend the following Training Course:

Person attending the Training Course

Cost of the Training Course

Course Payment Options

Agreement