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COURSE REGISTRATION FORM
 
     
Name of the Course (s) :
Course Date :
Cost :
PARTICIPANT INFORMATION
Name :
Company Name :
Address :
Telephone :
Mobile/ Contact :
Email :
PAYMENT INFORMATION
Name :
Name of the Bank :
Branch :
Account Number :
   

***  Payment must be received by EIHS office seven (7) days prior to the date of Course.

***  Refund will only be paid if cancellation is 7 days prior to the date of course

ONCE WE HAVE RECEIVED YOUR COMPLETED REGISTRATION FORM WE WILL CONTACT YOU AND CONFIRM DETAILS AND PROVIDE YOU WITH A CONFIRMATION NUMBER     ALONG WITH A RECEIPT UPON PAYMENT.

 
 
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