Electronic Registration Form
5 Day Leather Craft & Skills Training Course
COURSE INFORMATION
Location: *
Date from: *
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Date to: *
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PARTICIPANT DETAILS
Name & Surname: *
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ID Number: *
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Contact Number: *
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Email Address: *
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Postal Address:
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Dietary Requirements: *
Special Requests & Arrangements:
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EMERGENCY INFORMATION
Allergies: *
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Medical Aid:
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Membership Number:
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Emergency Contact Person: *
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Relation: *
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Contact Number (Emergency Contact Person): *
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Other Information:
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BILLING INFORMATION
(IF DIFFERENT FROM PARTICIPANT DETAILS)
Company Name:
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Company Physical/Postal Address:
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VAT Number:
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Company Contact Number:
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