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eNgiNeeriNg NatioNal techNical Diploma enrolment application Form - part 1
the program fees are per student and includereferencemanuals,livewebinars,assignments, software, programmaterials sent in electronic format andongoingsupport.You can “pause and restart” by joining asubsequent intake (a rejoining fee mayapply). We will allow up to 3 years fromyour original start date to complete theprogram.Youcanwithdrawfromtheprogramatanytime and receive a statement ofattainment for the modules you havecompleted. However, successfulcompletion of all modules will earn youthe
ANCELLAtIoNA fee equivalent to 1 monthly instalment(approximately 6% of the total program fee) willapplyforwrittencancellationsreceivedlessthan14 days prior to the start date of the program.Howeversubstitutesarewelcome.
CoNFIrMAtIoNofficialconfirmationofyourplacewillbesentbyemailwithin5businessdaysofacceptanceofyourapplication.Detailedprograminstructionswillbesupplieduponstartdate.
PLEASENotEIDC technologies has no affiliation withsuppliers or manufacturers and thereforepresentsacompletelyunbiasedfactualviewoftheindustry.
Instructorsmaychangewithoutnotice.
Webinarschedulesaresubjecttochange.
Unforeseen technical problems may occurresultinginthecancellationorreschedulingofwebinars.
PrIVACYINForMAtIoNIf your address details are incorrect, or youwishtoremoveyournamefromourmailinglist,pleasecontactusbyphone,faxore-mail(seebelow).
At times we make use of lists that cannot becross-checkedagainstourowndatabaseandyoumayreceiveaduplicate.Ifso,pleasepassthisontoaninterestedcolleague.
ENQUIrIESForfurtherinformation,pleasephone 0110245520/1/2/3.
DiplomaDetails
HowtoApply
PLACESArELIMItED -APPLYtoDAY!
NEWFLEXIBLE PAYMENtPLAN:
Payinmonthlyinstalments totakethepressureoff!
Shouldyouhavemorepeopleinterestedinparticipatinginthisprogram,pleasecontact uson0110245520/1/2/3oremail:[email protected]
3.PaymentDetails
StartDate: [email protected]
1.ProgramDetails
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ENGINEErINGNAtIoNALtECHNICALDIPLoMA: N4, N5, N6
StArtDAtE:
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INVoICING:INVoICEMYCoMPANY INVoICEME
StUDENtNAME(FirstName,LastName):
JoBtItLE:
ADDrESS:
PHoNES(IncludeCountryCode): 1.DAYtIME:
E-MAIL:
EMPLoYEr/CoMPANYNAME(Ifapplicable):
ADDrESSForINVoICING(Write"asabove"ifsame):
CoUNtrY:
2.StudentDetails[oneformperstudent]
2.MoBILE/CELL:
EMPLoYEr'SCoNtACtNAME(Ifapplicable):
E-MAIL:CoUNtrY:
PHoNE(IncludeCountryCode): DAYtIME:
PLEASEPrINtCLEArLY
rEtUrNINGStUDENt?YES NO
SUBUrB: ProVINCE: PoStCoDE:
SUBUrB: ProVINCE: PoStCoDE:
ByEmail:[email protected]
ByMail: IDCtechnologies
PoBox389 HalfwayHouse1685
ByFax:(086)6924368
ViaourWebSite:www.idc-online.com
PLEASENotE:PricesshownareexclusiveofVAt
FULLProGrAMoPtIoN1–PAYUPFroNt r8600 =r ____________________________
Paytotalamountupfront(atleasttwoweekspriortoprogramstart)
FULLProGrAMoPtIoN2–PAYIN6INStALMENtSBYCrEDItCArD(r1505.00perinstalment)Payin6easyinstalmentsover6months.Paymentdateswillbeadvisedaheadoftime.
6instalments(totalr9030.00) =r ____________________________
[email protected] 1.SubjectName: ____________________________________________________________________________________________________________________________________________________________ =r _____________________________ 2.SubjectName: ____________________________________________________________________________________________________________________________________________________________ =r _____________________________ 3.SubjectName: ____________________________________________________________________________________________________________________________________________________________ =r _____________________________
TOTAL =r ____________________________
Formoreinformationonpaymentdetailspleasecontactuson0110245520/1/2/3
PleaseNote:
Shouldyouwithdrawwithin14daysofthestartdate,wewillrefundyourpayment.However,afeeequivalentto1monthlyinstalment(approximately6%ofthetotalprogramfee)willberetained.
Iwishtopayby: ELECtroNICFUNDStrANSFEr(Foroption1aboveonly)
CoMPANYorDErNUMBEr: ________________________________________________________________
CrEDItCArD
Pleasechargemy: MAStErCArD VISA
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________CArDHoLDEr’SNAME:
CArDHoLDEr’SSIGNAtUrE:
EXPIrYDAtE:/
onthereverseofyourcard,abovethesignature,isasecuritynumber. Inordertoauthoriseyourcardtransaction,werequirethelast3digits:
IftheCardholder'saddressisnotthesame asshownabovepleasetickthisbox:
Ifyouwouldpreferustocontactyouforyourcard’sexpiryandsecuritycode,pleasetickthisbox:
FeeCode: ______________________________________________
