Registration Form

Enrolment Date:

Company Name: Tel No: Fax No: Company Email: Website: Postal Address: Postal Code: Physical Address: Physical Address Code: Province: Select your province Gauteng Western Cape Eastern Cape KwaZulu-Natal Free State Limpopo Mpumalanga Northern Cape North West Other Country: VAT Number: Company Registration No: Purchase Order No:

Please attach order form where relevant.

Surname (Last Name): Previous Surname: First Name: Middle Name: Initials: Title: Select Title Mr Mrs Ms Dr Prof ID No: Date of Birth: Alternative ID Type Select an option 521 – SAQA Member 527 – Passport 529 – Driver’s Licence 531 – Temporary 533 – None 535 – Unknown 537 – Student Number 538 – Work Permit 539 – Employee No 540 – Birth Cert 561 – ETQA Recor Gender Male Female Equity BA – Black African BC – Black Coloured BI – Black Indian U – Unknown WH – White Nationality Angola Other African Countries Australia and New Zealand U – Unknown Central and South America European Countries Lesotho Malawi Mauritius Mozambique N/A: Institution Namibia North American Countries Other and rest of Oceania Rest of Africa South Africa Swaziland Tanzania Zaire Zimbabwe Home Language Home Language"required Afrikaans English isiNdebele isiXhosa isiZulu sePedi seSotho seTswana siSwati South African Sign Language tshiVenda xiTsonga Other Citizen Resident Status Other Permanent Resident South Africa – SA Seeing 1 - no difficulty 2 - some difficulty 3 - a lot of difficulty 4 - cannot do at all 6 - cannot yet be determined 60 - may be part of multiple difficulties 70 - may have difficulty 80 - former difficulty (not now) Hearing 1 - no difficulty 2 - some difficulty 3 - a lot of difficulty 4 - cannot do at all 6 - cannot yet be determined 60 - may be part of multiple difficulties 70 - may have difficulty 80 - former difficulty (not now) Communicating 1 - no difficulty 2 - some difficulty 3 - a lot of difficulty 4 - cannot do at all 6 - cannot yet be determined 60 - may be part of multiple difficulties 70 - may have difficulty 80 - former difficulty (not now) Walking 1 - no difficulty 2 - some difficulty 3 - a lot of difficulty 4 - cannot do at all 6 - cannot yet be determined 60 - may be part of multiple difficulties 70 - may have difficulty 80 - former difficulty (not now) Remembering 1 - no difficulty 2 - some difficulty 3 - a lot of difficulty 4 - cannot do at all 6 - cannot yet be determined 60 - may be part of multiple difficulties 70 - may have difficulty 80 - former difficulty (not now) Self-care 1 - no difficulty 2 - some difficulty 3 - a lot of difficulty 4 - cannot do at all 6 - cannot yet be determined 60 - may be part of multiple difficulties 70 - may have difficulty 80 - former difficulty (not now) Tel No. (H): Tel No. (W): Cell No: Fax No: Email: Physical Address: Physical Address Code: Physical Municipality: Physical Urban/Rural Urban Rural Province Gauteng Western Cape Eastern Cape KwaZulu-Natal Free State Limpopo Mpumalanga Northern Cape North West Socio-Economic Status U – Unspecified 01 – Employed 02 – Unemployed/option> 04 – Homemaker 06 – Student 07 – Retired 08 – Unemployed - Disabled Highest Qualification: School Attended: Do you have any special needs we need to be aware of? Yes No If Yes, please give details:

Please submit certified copies of ID and Highest Qualification along with the enrolment form.

Where did you hear about ENJO Consultants? Referred by a colleague/friend Google Facebook LinkedIn Company I am working for Other If Other, please give details: Would you like to receive our email newsletter? Yes No Training Programme: Attendance Class Attendance Online Virtual Class Attendance Distance Learning (Self-Study) Would you like to receive the free complimentary light lunch? Yes No Please select diet: Normal Diet (Western) Vegetarian Diet

Skills Programme Enrolment Form

Contact Us

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