Application Form to register as a student

application Form to register as a student
Name

First NameLast Name
Gender
Citizenship
Date of Birth

MonthDayYear
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Application for Admission Information
Admission Application For
High School Education
Name of Last High School Attended
Year Graduated

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Highest Grade

work experience in the early years
Name of School
If you have no experience in the Early Years at a school, please complete this paragraph, and tell us about yourself and why you would like to enrol for a qualification in the early years.
Phone Number
Format: (000) 000-0000.
Name of Manager or Principal
Email of Manager
example@example.com
Number of Years Experience
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

personal documentation
Please upload your latest CV

Cancelof
Please upload a certified copy of your school certificate

Cancelof
Please upload a certified copy of your ID

Cancelof
I certify that the information I have provided above are true to the best of my knowledge without any malice or any intention to commit acts of misrepresentation.

I am aware that any false, misleading, or deceptive information provided may lead to withdrawal, expulsion, or any disciplinary action which may be dealt with by Early Childhood Teachers Training Institute.

I agree that a representative from Early Childhood Teachers Training Institute can contact me to provide a quotation for the qualification I indicated I want to register for.

I agree that by submitting this form it does not enroll me for the qualification, only after making payment will I be enrolled on Laser Learning Learners Platform and have access to the qualification.

I agree that Early Childhood Teachers Training Institute may freeze my account if I default on my monthly payments.
Disclaimer All parties agree that they will comply with POPI regulations and process all the information and/or personal data in respect of the services being rendered in accordance with the said regulation and only to provide the Services set out in the agreement to provide services. It is confirmed that by submitting information to Early Childhood Teachers Training Institute, irrespective of how such information is submitted, you consent to the collection, collation, processing, and storing of such information and the use and disclosure of such information in accordance with this policy. Early Childhood Teachers Training Institute (the provider), all the parties to this agreement, the service provider’s employees and the client’s employees and any subsequent party/parties to this agreement acknowledge and confirm that; One or more of the parties to this agreement, will possess and will continue to possess information that may be classified or maybe deemed as private, confidential or as personal information. Such information may also be deemed as or considered as private, confidential or personal information of any third person who may be directly or indirectly associated with this agreement. Further, it is acknowledged and agreed by all parties to this agreement, that such private, confidential or personal information may have value and such information may or may not be in the public domain. Further, it is specifically agreed that the Early Childhood Teachers Training Institute will use its best endeavours and take all reasonable precautions to ensure that any information provided, is only used for the purposes it has been provided.
Name of Applicant

First NameLast Name
Date Signed by Applicant

MonthDayYear
Date
Applicant's Signature
Should be Empty:

application Form to register as a student

Application for Admission Information

High School Education

work experience in the early years

personal documentation