KZNPPHC TRAINING ACADEMY APPLICATION FORM

Section 1: NAME & CONTACT DETAILS OF APPLICANT


A description of the section goes here.







Section 2: BIOGRAPHICAL INFORMATION





Gender
South Africa Citizenship


If you have been trained by KZNPPHC before, state type of training done:

State type of traning received:

Do you have any health conditions that need to be considered?

If yes, please specify:

Do you have any physical disability?

If yes, please specify:

Section 3: PROVIDE QUALIFICATIONS


If you are studying at the moment, please provide the following details:






Provide details of all qualifications obtained





Payment for training:

Section 4: WORK RELATED EXPERIENCE


Employment Status:

Present employer (if employed)


If self employed, provide brief details:

Brief job description

Indicate why you should be accepted for the skills programme:

Section 5: REFERENCES













Banking Details:
The application form is at a non-refundable fee of R200-00.
A deposit should be made out to KZNPPHC account (cash will not be accepted),

Account name: KZNPPHC
Bank: Nedbank,
Branch code: 130526
Account number: 1305866827
Type of account: Cheque account

Please Note:
1. Attach deposit slip and certified copy of your grade 12 certificate and Identity document, when returning the form
2. Please use your ID number as your reference when making payment
3. Incomplete application forms will not be considered
4. If you are uncertain about any aspect of your application, please contact the office at 031-303 1014.
5. Filling in these forms does not guarantee acceptance

DECLARATION
I hereby declare

1. That all additional documentation required in terms of instructions as described in this page of the application form, is included with this application form and that I am aware of and accept the fact that incomplete applications will not be considered.
2. That the information submitted with this application is true and accurate
3. That KZNPPHC may cancel my registration immediately should it become apparent that any information submitted with this application is untrue, inaccurate, or intended to mislead

By submitting this form you agree to the declaration *
I confirm I have read the declaration and all informatoin given is true and accurate.