Learner Information

ENROLLMENT 2017

LEARNER INFORMATION

SECTION 1: PERSONAL DETAILS:

Title: Mr Mrs  Miss  Other – (Specify):

As in identity document please specify:

SURNAME:
FULL NAMES:

Type of ID: RSA  Non-RSA

Nationality: RSA  Other(Specify):

Identity No:

Passport No:

If OTHER, attach certified copies of documents indicating your status e.g. Passport,Permanent residence, Study permit, etc.)

Date of birth:

Gender: Male  Female

Population Group: AfricanColoured  Asian  White  Other (Specify):

Marital Status:SingleMarried  Divorced Widowed

Do you have a disability, as contemplated in the Employment Equity Act 55 of 1998[1]? No  Yes (Specify):

______

______

______

______

CONTACT DETAILS: (You must provide at least one phone number where you can be reached. Both physical AND postal addresses MUST be completed.)

Tel No (h): ______Tel No (w): ______

Cell phone No:______E-mail:______

Physical Address:______

______

Postal Address:

______

______

Province: Gauteng  Western Cape  Mpumalanga  Eastern Cape  Limpopo  Northern Cape

 Free State  North West  KwaZulu-Natal

SCHOOLQUALIFICATIONS1:

School where qualification was obtained:

Highest school qualification: Grade 8 Grade 10 Grade 12

HIGHEST TERTIARY QUALIFICATION:
Institution where qualification was obtained:

LANGUAGES1:

Home Language: / Zulu, English, Ndebele, Northern Sotho, Sotho,
Swazi, Tsonga, Tswana,  Venda, Xhosa, Afrikaans

SECTION 2: Which course would you like to enrol for?

I hereby apply to enrol for the following course(s) and confirm that I meet the required admission requirements:

Course Name

______

______

______

SECTION 3: STUDENT/GUARANTOR DETAILS

Title: Mr Mrs  Miss  Other – (Specify):

SURNAME:
FULL NAMES:

Identity No:

Relationship to student

Tel No (h): ______Tel No (w): ______

Cell phone No:______E-mail:______

Physical Address:______

______

Postal Address:

______

______

Province: Gauteng  Western Cape  Mpumalanga  Eastern Cape  Limpopo  Northern Cape

 Free State  North West  KwaZulu-Natal

SECTION 4: TO BE COMPLETED IF THE ACCOUNT PAYER IS A BUSINESS

Company Name:______

Business Registration No ______

VAT Number: ______SDL Number:______

Postal Address: ______

______

______

Physical Address:______

______

______

Telephone Number:______Fax Number: ______

Authorising Manager: ______

Authorising Signature: ______

TERMS & CONDITIONS

It is understood that once this document, inclusive of the Trainee Name list attached, have been signed by the client, all bookings will be regarded as accepted and confirmed.

LIMITATION OF LIABILITY

The client indemnifies and holds Hadassah Security Consultants cc, its Director(s), employees or agents harmless against any claim of whatsoever nature which may be made against any of them resulting from or occasioned by the function, including but not limited to personal injury, death, loss of, or damage of property, brought onto, or left on the company property, or any other training venue, or any claim for any loss or damages suffered by the client.

TRAINING FEES

Upon receipt and acceptance of the quotation an official order number must be supplied by the client to Hadassah Security Consultants who will then invoice the client. In the event of an individual trainee not registered by his company or in his private capacity, the acceptance and signing of this document will be regarded as acceptance to the conditions enclosed herein.

All invoices are due for payment on receipt and prior to the commencement of any training programme. No delegate will be allowed to attend any classes in the event of non-payment of course fees.

In the event of an agreement between the client and Hadassah Security Consultants that trainees attending to a training session / workshop prior to payments received by Hadassah Security Consultants it will be an understanding by the client that NO Examination papers, Formative- or Summative Assessments will be marked by the Instructor or Facilitator.

All training sessions must be confirmed in advance not later than four weeks prior to the commencement of any training session / workshop. Trainee name lists must be submitted to Hadassah Security Consultants cc without delay. Companies are welcome to make name changes up to one week prior to the training session / workshop

In the event of Hadassah Security Consultants cancelling the training session / workshop, all paid fees, less a 10% administration fee, will be refunded to the client.

Any cancellation by the client will carry a cancellation fee of 75% - within 7 to 14 days prior of the scheduled training session and a 100% cancellation fee less than 7 days prior to the scheduled training session. Any trainee failing to attend the training course on the scheduled dates after payments were made to Hadassah Security Consultants, will forfeit the full training course fees. It would then be to the discretion of Hadassah Security Consultants and in negotiation with the client to accommodate the trainee at a next training session or not. In any event the training course must be attended within 30 days after original training dates. In the event of non-attendance after rescheduling the training course, the client will forfeit the full training course fee and will have to re-register as for the first time attending to a training course.

Hadassah Security Consultants will not be liable for losses incurred in the event of a booking cancellation, if individuals postpone due to a fortuitous event unforeseen by delegates or due to the occurrence of an act of God or any other event that may be the cause of such.

Accommodation and Airline and/or any other travel arrangements and accommodation remain ultimately the responsibility of the delegate when attending to training session at our venue in Pretoria.

In the event of Hadassah Security Consultants personnel needs to travel outside a radius of 50 km from the premises of Hadassah Security Consultants, the travelling, accommodation and training venue will be for the account of the client. The vehicle travelling rates will be calculated at the standard AA rates for the vehicle in use – or the option of making use of an air flight which option would be the cheaper. In the event of an air flight being used, a vehicle must be rented for use between accommodation, training venue and the airport.

Accommodation could be arranged by either parties but must be of an acceptable standard –at least a 4 star rating - double bed, fridge and air conditioning is a prerequisite and is not negotiable.

Performance Event Programme content and Facilitators are subject to change without NOTICE.

Above conditions accepted:

Signed at ______on this _____ day of ______201___

Signature______

CONTACT DETAILS:

Hadassah Viljoen Fax +27 86 605 9250 or Email to: