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  • Short Course Registration Form

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    justinsabene52
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    This document is an application form for short intensive courses at Northern Technical College's Management Board. It requests information such as name, date of birth, contact details, occupation, course applying for, education history, and declaration of truth of information provided and agreement to abide by college rules. The form is to be returned to the Business Development Office once payment is made for certification purposes.

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    This document is an application form for short intensive courses at Northern Technical College's Management Board. It requests information such as name, date of birth, contact details, occupation, course applying for, education history, and declaration of truth of information provided and agreement to abide by college rules. The form is to be returned to the Business Development Office once payment is made for certification purposes.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    4 views1 page

    Short Course Registration Form

    Uploaded by

    justinsabene52
    This document is an application form for short intensive courses at Northern Technical College's Management Board. It requests information such as name, date of birth, contact details, occupation, course applying for, education history, and declaration of truth of information provided and agreement to abide by college rules. The form is to be returned to the Business Development Office once payment is made for certification purposes.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 1

    NORTHERN TECHNICAL COLLEGE

    MANAGEMENT BOARD

    APPLICATION FORM FOR SHORT INTENSIVE COURSES

    SURNAME: ------------------------------------------------------------------------------------------------

    OTHER NAMES: ------------------------------------------------------------------------------------------

    DATE OF BIRTH: ------------------------------------NRC NO: -----------------------------------------

    RESIDENTIAL ADDRESS: -------------------------------------------------------------------------------

    TEL NO: /CELL NO.------------------------------------------------FAX NO: ----------------------------

    OCCUPATION: ---------------------------------------------------------------------------------------------

    COURSE APPLIED FOR: ----------------------------------------------------------------------------------

    NAME OF SPONSOR: --------------------------------------------------------------------------------------

    BUSINESS ADDRESS: -------------------------------------------------------------------------------------

    TEL NO: -------------------------------------------------FAX NO: ----------------------------------------

    LAST SEC SCHOOL ATTENDED: ------------------------------------------------------------------------

    QUALIFICATION ATTAINED: ----------------------------------------------------------------------------

    LAST COLLEGE ATTENDED: ------------------------------------------------------------------------------

    QUALIFICATION ATTAINED: -----------------------------------------------------------------------------

    DECLARATION

    I HEREBY DECLARE THAT THE INFORMATION PROVIDED ABOVE IS CORRECT AND THAT I AGREE TO
    ABIDE BY THE RULES AND REGULATIONS OF THE COLLEGE.

    DATE: ------------------------------SIGNATURE-----------------------------------------------------------------------------

    FOR OFFICIAL USE ONLY

    NORTEC HEAD OF DEPT: --------------------------------SIGNATURE -------------------DATE: ------------------------

    RECIEPT NO: ----------------------------ENROLMENT NO: ---------------------------------------------------------------

    AMOUNT PAID: --------------------DATE: ----------------------SIGN------------------------------------------------------


    A/C No 0388316300125, Account Name: NORTEC RECURRENT, Bank Name: ZANACO WEST
    Branch NDOLA

    BUSINESS DEV. OFFICE: -----------------------------SIGNATURE: ------------------------DATE: -----------------------

    NOTE: Please return this form to Business Dev. Office once payment has been done for
    certification purpose.

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