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  • eNgiNeeriNg NatioNal techNical Diploma NEW FLEXIBLE ... · V0001 eNgiNeeriNg NatioNal techNical Diploma enrolment application F orm - part 1 the program fees are per student and include
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V0001 ENGINEERING NATIONAL TECHNICAL DIPLOMA ENROLMENT APPLICATION FORM - Part 1 the program fees are per student and include reference manuals, live webinars, assignments, software, program materials sent in electronic format and ongoing support. You can “pause and restart” by joining a subsequent intake (a rejoining fee may apply). We will allow up to 3 years from your original start date to complete the program. You can withdraw from the program at any time and receive a statement of attainment for the modules you have completed. However, successful completion of all modules will earn you the ANCELLAtIoN A fee equivalent to 1 monthly instalment (approximately 6% of the total program fee) will apply for written cancellations received less than 14 days prior to the start date of the program. However substitutes are welcome. CoNFIrMAtIoN official confirmation of your place will be sent by email within 5 business days of acceptance of your application. Detailed program instructions will be supplied upon start date. PLEASE NotE IDC technologies has no affiliation with suppliers or manufacturers and therefore presents a completely unbiased factual view of the industry. Instructors may change without notice. Webinar schedules are subject to change. Unforeseen technical problems may occur resulting in the cancellation or rescheduling of webinars. PrIVACY INForMAtIoN If your address details are incorrect, or you wish to remove your name from our mailing list, please contact us by phone, fax or e-mail (see below). At times we make use of lists that cannot be cross-checked against our own database and you may receive a duplicate. If so, please pass this on to an interested colleague. ENQUIrIES For further information, please phone 011 024 5520/1/2/3. Diploma Details How to Apply PLACES ArE LIMItED - APPLY toDAY! NEW FLEXIBLE PAYMENt PLAN: Pay in monthly instalments to take the pressure off! Should you have more people interested in participating in this program, please contact us on 011 024 5520/1/2/3 or email: [email protected] 3. Payment Details Start Date: Please contact [email protected] 1. Program Details _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ ENGINEErING NAtIoNAL tECHNICAL DIPLoMA: N4, N5, N6 StArt DAtE: _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ INVoICING: INVoICE MY CoMPANY INVoICE ME StUDENt NAME (First Name, Last Name): JoB tItLE: ADDrESS: PHoNES (Include Country Code): 1. DAYtIME: E-MAIL: EMPLoYEr/CoMPANY NAME(If applicable): ADDrESS For INVoICING (Write "as above" if same): CoUNtrY: 2. Student Details [one f orm per student] 2. MoBILE/CELL: EMPLoYEr'S CoNtACt NAME (If applicable): E-MAIL: CoUNtrY: PHoNE (Include Country Code): DAYtIME: PLEASE PrINt CLEArLY rEtUrNING StUDENt? YES NO SUBUrB: ProVINCE: PoSt CoDE: SUBUrB: ProVINCE: PoSt CoDE: By Email: [email protected] By Mail: IDC technologies Po Box 389 Halfway House 1685 By Fax: (086) 692 4368 Via our Web Site: www.idc-online.com PLEASE NotE: Prices shown are exclusive of VAt FULL ProGrAM oPtIoN 1 – PAY UPFroNt r8600 =r ____________________________ Pay total amount upfront (at least two weeks prior to program start) FULL ProGrAM oPtIoN 2 – PAY IN 6 INStALMENtS BY CrEDIt CArD (r1505.00 per instalment) Pay in 6 easy instalments over 6 months. Payment dates will be advised ahead of time. 6 instalments (total r9030.00) =r ____________________________ INDIVIDUAL SUBJECtS @ r2150.00 PEr SUBJECt 1. Subject Name: ____________________________________________________________________________________________________________________________________________________________ =r _____________________________ 2. Subject Name: ____________________________________________________________________________________________________________________________________________________________ =r _____________________________ 3. Subject Name: ____________________________________________________________________________________________________________________________________________________________ =r _____________________________ TOTAL =r ____________________________ For more information on payment details please contact us on 011 024 5520/1/2/3 Please Note: Should you withdraw within 14 days of the start date, we will refund your payment. However, a fee equivalent to 1 monthly instalment (approximately 6% of the total program fee) will be retained. I wish to pay by: ELECtroNIC FUNDS trANSFEr (For option 1 above only) CoMPANY orDEr NUMBEr: ________________________________________________________________ CrEDIt CArD Please charge my: MAStErCArD VISA ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ CArDHoLDEr ’ S NAME: CArDHoLDEr ’ S SIGNAtUrE: EXPIrY DAtE: / on the reverse of your card, above the signature, is a security number. In order to authorise your card transaction, we require the last 3 digits: If the Cardholder's address is not the same as shown above please tick this box: If you would prefer us to contact you for your card’s expiry and security code, please tick this box: Fee Code: ______________________________________________

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Page 1: eNgiNeeriNg NatioNal techNical Diploma NEW FLEXIBLE ... · V0001 eNgiNeeriNg NatioNal techNical Diploma enrolment application F orm - part 1 the program fees are per student and include

V0001

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

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

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: ______________________________________________

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PROGRAM NAME:
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Register today to secure your place. You will only be invoiced in November 2014.
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Payments due prior to the start of the course.
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relevant National Technical Diploma.
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