Academy Registration

Course / Programme*
Name of Participant*
Full name as in ID / Passport (This name will be captured for billing and certificate purposes)
Date of Birth*
Date Format: DD dash MM dash YYYY
Age*
Gender*
- Male
- Female
IC / Passport no.*
Address*
Street Address City State Postcode Country
Phone (mobile)*
Phone (home)
Phone (office)
Fax
Email*

Kindly make sure your email address is correct as that will be our mode of communication
Occupation
Notes
Other courses interested in
Signature (Participant)*
Parent's Consent
For participants below 18 years old
Name of Parent*
Prefix First
“I hereby give my consent for my child to participate in the above course.”
Signature (Parent)*

Please note:

Parent's Consent