COURSE REGISTRATION FORM - HSP Consultants

 COURSE REGISTRATION FORM

 

Please complete the form (as much as possible) and email it to afrepton@gmail.com

COURSE  TITLE, PROPOSED  DATE AND CITY/VENUE
PARTICIPATION (Physical or Online):
From where/who did you receive the course invitation?
PERSONAL DETAILS
Last Name(s):		First Name(s):
Gender: [  ] Male       [  ] Female		Marital Status: [  ] Single         [  ] Married
Postal Address:
Physical Address (if different from above):
Telephone (plus country and local code):		Skype ID (If any):
Mobile/Cell Phone:		Personal E-mail Address:
Date of Birth:		Country of Residence:
EMPLOYMENT  DETAILS
Employer’s Name:
Address:
Telephone (plus country and local code)		E-mail Address:
Brief outline your responsibilities:
COURSE HISTORY
Have you participated in any of our training courses before? If yes, indicate the course title:
THIS COURSE IS CURRENTLY PROVIDED IN ENGLISH LANGUAGE
Please indicate below your knowledge (excellent, good, fair, or poor) of the English Language
Reading	Writing			Speaking
PROFESSIONAL GOALS
Please write a statement of not more than 100 words, explaining why you wish to participate in this training and how the training will help you achieve your goals.
MOTIVATION
What do you expect to gain from your participation in the course?
PERSONAL INFORMATION
Please print clearly the email address you will be using for the course:
Do you have access to Internet?      [  ] Yes          [  ] No
The Candidate
By submitting this form, I confirm that I have paid the prescribed course registration fee. I shall inform the organizers at least 7 days before course commencement if I am unable to attend this course. I certify that to the best of my knowledge, the information provided in all parts of this form is accurate and complete.
Signature (or name):			Date:

 

 

Please email completed application to: afrepton@gmail.com