Registration Form1

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Documents to be submitted with Registration Form COURSE FEE: N$900.

00
• Certified copy of ID document/passport Banking Details:
• Certified copy of highest school certificate (If Account Name: Namibia Community Skills Development Foundation
applicable) Account Number: 8000467625
• Curriculum Vitae (If applicable) –Not more than 4 Bank Name: Bank Windhoek
Branch Code: Swakopmund (481-772) Account Type: Cheque
pages
Closing date for Applications: 11 June 2021 - NO LATE APPLICATIONS WILL BE CONSIDERED.
Individual Registration (Single Participant):
PLEASE COMPLETE ALL FIELDS (Compulsory) or mark with X where applicable
Personal Particulars:
Surname: Title: Mr Ms
First Name(s) in full:
Date of Birth: ID/Passport Number:
Contact Details:
Postal Address:
Office ( + Code): Cell: E-mail:
Do you have any disability? Yes No (for planning purposes only)
If yes, based on your disability, do you have special needs? Yes No
Do you suffer from any other illness? If ‘yes’ please give details of the nature and/or severity Yes No
(for planning purposes only)
School Leaving Particulars
Last secondary school attended:
Highest grade passed: (please submit certificate/latest school report):
Employment details (please submit cv, if applicable)
Employer: Occupation:
Company Registration (more than 1 delegate):
Surname Full Name(s) Company Name Occupation Cell Number E-mail Address

TERMS & CONDITIONS


1. This registration form, once completed, signed and received by COSDEF, shall be considered as a contractual document that obliges participants to promptly fulfill
payment responsibility. 100% payment of the N$900.00 course fee shall be required to accompany this registration form.
2. Incomplete registration forms will not be considered.
3. Should the participant not be able to make payment upon registration, the participant will then be held liable to ensure that the payment is received by
COSDEF not later than 5 working days before the commencement of the course.
4. Cancellations must be made in writing and must be received by COSDEF not later than 5 working days before the date of the course. N$100.00 will be forfeited
due to administration fees. No refund will apply after the stated period.
5. In the event of unforeseen circumstances, we reserve the right to change the program, dates or venue.
DECLARATION:
I acknowledge that I have read, understood and accept the Terms and Conditions (including Payment Terms) and I hereby declare that all the particulars given
in this application form are true and correct. I apply for registration on behalf of myself (if a single delegate) or on behalf of the above-mentioned organisation
which I am duly authorised to represent.

SIGNATURE: ____________________________________ Date: _____________________

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