1. Personal Information
- Full Name (as it should appear on your certificate):
[Text Box]
- Gender:
[ ] Male
[ ] Female
[ ] Other
[ ] Prefer not to say
- Date of Birth:
[Date Picker]
- Nationality:
[Text Box]
- Contact Information:
- Phone Number:
[Text Box]
- Email Address:
[Text Box]
- Emergency Contact Name:
[Text Box]
- Emergency Contact Number:
[Text Box]
2. Address Details
- Residential Address:
[Text Box]
(Street Address, City, Postal Code)
- Preferred Method of Communication:
[ ] Email
[ ] Phone
[ ] Text Message
3. Educational Background
- Highest Level of Education Completed:
[ ] High School
[ ] Associate’s Degree
[ ] Bachelor’s Degree
[ ] Master’s Degree
[ ] Doctorate
[ ] Other: [Text Box]
- Field of Study (if applicable):
[Text Box]
4. Course Details
- Course Name:
[Dropdown List of Courses]
(Choose the course you wish to enroll in, e.g., “Introduction to Digital Marketing,” “Project Management Certification,” etc.)
- Preferred Course Mode:
[ ] Online
[ ] In-Person
[ ] Hybrid (Online + In-Person)
- Preferred Course Start Date:
[Date Picker]
- Have you participated in any previous courses with SayPro?
[ ] Yes
[ ] No
5. Payment Information
- Course Fee:
[Text Box] (e.g., $300 or “Free” if applicable)
- Payment Method:
[ ] Credit Card
[ ] Bank Transfer
[ ] PayPal
[ ] Scholarship/Financial Aid (if applicable)
- Discount/Promo Code (if applicable):
[Text Box]
6. Special Needs or Accommodations
Please inform us of any specific accommodations or support you may need during the course:
[Text Box]
7. Terms and Conditions
Please read and accept the following terms and conditions before submitting your registration.
- I agree to comply with the course requirements and deadlines.
- I understand that fees are non-refundable after the course has started, unless otherwise stated.
- I consent to having my personal details used for course administration and communication purposes.
- I give permission for SayPro to use my feedback for marketing and promotional purposes (if applicable).
[ ] I accept the terms and conditions.
8. Submit Registration
After filling out the registration form, please click Submit below to complete your enrollment.
[Submit Button]
9. Confirmation and Follow-Up
Once you submit your registration, you will receive an email confirming your enrollment and additional details on the course schedule, payment instructions (if applicable), and any preparation materials.
Additional Notes:
- If you are required to submit documents such as proof of identity, academic qualifications, or a resume, please upload them [here]: [Upload Button]
- For any questions or assistance with the registration process, please contact us at:
Phone: [Insert Phone Number]
Email: [Insert Email Address]
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