Registrations – Moetapele Academy

Registrations

To register at Moetapele Academy, please fill out the form below.

Registration Form

Enrolling For (Course Name) *
Enrollment Type *
Full TimePart Time

Learner Details

Title *
First Names *
Surname *
ID Number *
Gender *
Race *
Employment Status *
Employer *
Citizenship *
Passport Number
Nationality *

Contact Details

Home Tel
Work Tel
Cell: *
Email *
Residential Address (Including Code) *

Education

Highest Grade *

Next of Kin

Name *
Relationship *
Phone *

Payment Details

Sponsor / Payer *
SelfCompany
Company Name / Sponsor
Company Registration Number
HR Manager Name
Title *
First Names *
Surname *
ID Number *
Home Tel
Work Tel
Cell *
Fax
Email Address *
Residential Address (Including Code) *

Verification

Please enter any two digits below *Example: 41
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