XpRienz Course Registration Form
SSG Accredited WSQ Lifestyle Courses
XpRienz Pte Ltd - UEN 200409177Z
Choose your course *
Full Name *
Enter Full Name as in your Identification Document
NRIC no. *
Enter only the last 4 digits/alphabets (e.g. SXXXX123A)
Mobile contact number *
Date of birth *
MM
/
DD
/
YYYY
Gender *
INDIVIDUAL / COMPANY? (If company please state the full company's name) e.g. Self sponsor key "IND" / Company sponsor key in name of company.
Residential status *
Race *
Highest Education Level
Postal code *
DECLARATION/ ACCEPTANCE 1. I hereby declare that the above personal information given is true and correct. 2. I hereby consent that Xprienz Pte Ltd is allowed to use the information provided above for all matters related to the course(s) I have attended. 3. I hereby acknowledge that the training provider will not be held liable to resubmit the result should there is error found on the Name and/or identification number after the course has ended. 4.I hereby consent to XpRienz's use of any images or videos taken before, during or after the course. 声明/接受 1.我在此声明以上我所提供的个人信息是真实正确的。 2.我同意允许Xprienz Pte Ltd使用我以上提供的资料用于我参与的课程相关事项。 3. 我特此了解,如果在课程结束之后发现姓名或身份证号码有误,培训公司则不负责重新提交成绩。 4.我特此同意XpRienz使用在课程之前,之中或之后拍摄的任何图像或视频 *
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