CPD Workshops Registration

REGISTRATION FORM

Please take note: Every individual must complete his / her own Registration Form.

GENERAL INFO

First Name:

Surname:

Profession:

SACSSP No:

Organisation:

Postal Address:

Postal Code:

Email:

Telephone:

Cellphone:

Language:

COURSE INFO

Name of course that you wish to attend:

Area / venue of course you wish to attend:

Online

Name to appear on attendance certificate:

MEDICAL INFO

Do you suffer from any medical condition that we should be aware of:

Yes No

If 'yes' (medical condition), please specify.

PAYMENT DETAILS

Bank Details:
Account Name: CEFA
Bank: Standard Bank
Branch: Tyger Manor
Branch Code: 051001
Account Type: Cheque
Account Number: 083 048 030

For us to allocate the payment correctly

Please use your name and surname as payment reference
Please send proof of payment together to cpd@cefa.co.za

Please see below Terms and Conditions regarding a) relevant deposits which are payable with registration to ensure your place in a particular course & b) when the balance of payment is due.

TERMS AND CONDITIONS

No registration will be accepted without proof of payment.
25 % of course fees are non-refundable when cancelling attendance to a course less than 10 days prior to the start of the course.
Receipts for payments are available on request.
Dates and times are subject to numbers.
The individual attending the course,remains responsible for payment of course fees.6.All course materials are subject to copyright

I have read the Terms and Conditions relevant to the course I wish to attend and I understand that a non-refundable amount of 25 % of the course fees will be retained in case of cancellation less than 10 days prior to the start of the course. I understand that I, as an individual attending the course remains responsible for payment of course fees.

Signature: