Student Registration Form

Why We Request This Information
As a registered educational institution, we are legally required to maintain a secure student file for each learner, even for online courses. This file must include personal and academic details to comply with national education regulations and quality assurance standards. The information you provide is used to:

  • Verify your identity and eligibility for the course

  • Ensure accurate academic records and certificates

  • Meet statutory reporting requirements

  • Support you effectively throughout your studies

We treat your personal data with strict confidentiality and will never share it without your consent, unless required by law. Thank you for helping us maintain the integrity and recognition of your qualifications.

Your Details

Email *
Username *
Password *
Confirm Password
What Title Are You Addressed By *
First Name *
Surname *
Full Names *
A Passport Photo Of Yourself *
Maximum file size 1
Website
Must start with https://
Home Telephone Number
Work Telephone Number
Cellphone Number *
Postal Address
Postal Code
Residential Address Line One
Address Line Two
Postal Code
Country
Email Address
Marital Status
Date of Birth
ID Number *
A Copy Of Your ID *
Maximum file size: 1

Other Information

Primary Education

Name Of Highschool
Town
Highest Standard Attained
Year Obtained
Certifications
Maximum file size: 1
University Or College Name
Year Obtained
Degree Or Diploma
Maximum file size: 1

Other Education

Name Of Institution
Year Obtained
Certifications
Maximum file size: 1 MB
Name Of Institution
Year Obtained
Certifications
Maximum file size: 1 MB
Name Of Institution
Year Obtained
Certifications
Maximum file size: 1 MB
Name Of Institution
Year Obtained
Certifications
Maximum file size: 1 MB
Name Of Institution
Year Obtained
Certifications
Maximum file size: 1 MB

Employment

Current Employment
Current Position
Employer
Short Courses Completed
Certifications
Maximum file size: 1
Field Of Practical Experience As Practitioner
Signature *
Date