REGISTRATION

UNDER CONSTRUCTION

PLEASE -- E-Mail sonja@cctraining.co.za if you want to register for a course

Please choose your course*

Please Select Your Date*

I confirm that I am in possession of a valid, non-expired AHA Card (BLS/ACLS/PALS) OR have just registered for a BLS course.

Please email a copy of your CARD to sonja@cctraining.co.za before attending your course.

Please Select Your Date*

I confirm that I am in possession of a valid, non-expired AHA Card (ACLS/ACLS EP).

Please email a copy of your CARD to sonja@cctraining.co.za before attending your course.

Please Select Your Date*

I confirm that I am in possession of a valid, non-expired AHA Card (PALS/PALS EP).

Please email a copy of your CARD to sonja@cctraining.co.za before attending your course.

Please Select Your Date*

Your Title*

First Name*

Surname*

Date of Birth*

ID Nr*

HPCSA Nr:

Dietary Requests

Select (if required)

Specify (if other)*

Your Contact Details

Textbook Address*

Physical Address*

Postal Code

Telephone Number

Cellphone Number*

Fax Number

Email Address*

Cancellation/Postponement Clause

If you wish to cancel or postpone your course less than 6 weeks prior to the course date, no refund will be given. Postponement fee is R2000 for advanced courses and R600 for BLS. Full refund minus the fees of the books (if you received manuals) will be given if cancellation or postponement is done more than 6 weeks prior to the course date. By selecting this form you declare that the information furnished by you in the online application form is to the best of your knowledge true and correct. You also acknowledge our company policy with regards cancellations and postponements.

I accept the cancellation/postponement clause