CPD Public Course - Online Enrolment Form

Please use Title Case when completing this enrolment form. Ie Capitalised the First Letter of Each Word.

Personal details

First Name

Second Name

Maiden Name

Surname

Identity Number

Email Address

Cell Phone Number

Correct format: Only use numbers i.e. 0211231231

Physical Address

Company Name

Number & Street Name

Suburb

City

Province

Country

Postal Code

Past study related information

Qualifications

Membership of Professional Body

Course Fee

PLEASE NOTE: Access to our CPD Course Material is FREE, however there is a charge of R100 (including VAT) per Module should you require a Certificate of Completion.

Do you require a certificate?

Yes No

Please provide the below details for invoicing purposes:

Invoice Addressee (for example Company Name or Department Name – for Company Invoices or Personal Name – for Personal Invoices)

VAT Number for Invoice (where recipient is a VAT Vendor)

Contact Person for Invoice

Postal Address for Invoice

City for Invoice

Province for Invoice

Postal Code for Invoice

Country for Invoice

Contact Telephone Number for Invoice

Correct format: Only use numbers i.e. 0211231231

Fax Number for Invoice

Correct format: Only use numbers i.e. 0211231231

Email Address for Invoice