Title

Initials

Name

Middle Name

Surname

RSA ID Number

Date of Birth

Gender
---MaleFemale

Ethnic Group

Nationality

Home Language

Disability Status

Communication Method
---EmailFax

Email Address

Mobile Number

Fax Number

Address

Employment
---Company OwnerEmployeeSelf-Employed

Level of Plumbing Competence
---4 YearsMore than 4 YearsQualified

Invoice Details

Company / Individual

VAT Number

Phone Number

Fax Number

Email Address

Address

Payment Method
---EFTCredit Card

Course Cost R4,500.00 (VAT inclusive) per candidate.

Payment via EFT must be received prior to the candidate attending the course.

Payment by credit card can be made on the course date.

An invoice will only be issued on the day of the candidate’s attendance.

The candidate may request in writing only, to defer or postpone the date of the course to an alternative date as set by Kwikot, should the candidate not be able to attend. Cancellation by the candidate or by a third party paying for the course, or non-attendance by the candidate, will result in the amount paid been forfeited and is not refundable.

I certify that my answers are true and correct to the best of my knowledge:
Yes