Oxbridge Academy Registration Form Template

Fillable Printable Oxbridge Academy Registration Form Template

Oxbridge Academy Registration Form Template

REGISTRATION FORM

Oxbridge

Academy

effortless excellence in education

Course name:

Course Code:

I declare that I am fully aware of the accreditaon status of the selected course, the cercaon agent/party and the nature of the course.

STEP 1 - Course Selecon

Follow these easy steps and start your journey to success.

Job Status: Unemployed Employed

Occupaon:

Company/Work Name:

Highest School Grade Passed*: Year Grade Passed:

Other Qualicaons:

*Aach proof of highest grade/other qualicaons passed

Student Signature: Date:

Jan 2015

Student Advisor:

ID/Passport No*: Date of Birth:

Full Names:

Surname: Mr Ms Mrs

Email Address:

Cell No:

Work No:

STEP 2 - Student details

*Aach proof of ID

Code:

Postal Address:

Code:

Delivery Address (Work address preferred):

Race: African White Coloured Asian

Registraon fee payable upon registraon either by cheque, postal order, bank deposit, electronic transfer or ATM deposit.

Enclose the registraon fee when subming this form and we will send you a Welcome Pack that includes your 1st Study

Unit, Success Study Guide and Student card. Internaonal students will be required to pay a deposit of R2400.

STEP 4 - Registraon Fee

*Aach proof of payment

STEP 3 - Delivery Opons (ck your preference)

Delivery Opon Delivery Time Fees

Registered Post

(PO Box address)

7 - 14 working days Included in course price

* Courier

(Work address) Preferred

5 working days Included in course price

Rural areas courier

(street address must be supplied)

7 - 14 working days Included in course price

* Our courier service provider

does cover a wide area but

if not available in your area,

Registered Post will apply

Parent/Guardian/Guarantor Signature:

Parent/Guarantor Details

I approve and conrm this applicaon.

Name: Relaon to student:

ID No:

Cell No:

Home No:

IF YOU ARE: (A) YOUNGER THAN 18 YEARS OR (B) UNEMPLOYED

Payment via Bank Deposits

Bank Name ABSA Bank

Branch Code 632005

Account Name Oxbridge Academy

Account Number 4079189340

Reference Your Tel no & Name

Oxbridge Academy Bank Details

RSA - Tel:

021 110 0200

021 200 6236

Physical Address:

19A Oewerpark,

Rokewood Avenue

Stellenbosch, 7613

Postal address:

P.O. Box 12723,

Die Boord, 7613

E-mail: info@oxbridgeacademy.co.za

Website: www.oxbridgeacademy.co.za

RSA - Fax:

021 883 2378

086 111 2121

086 262 5550

Internaonal:

Tel: +2721 883 2454

Fax: +2721 883 2378

Fees - Tel:

021 110 0201

021 200 6237

Fees - Fax:

021 883 2437

• I declare that, aer entering into this agreement, I sll have sucient means to support myself.

• Should I fail to make any payment I owe, the full amount of the balance I owe shall become immediately payable; Oxbridge Academy shall be entled

to proceed against me for recovery without further noce.

• If I am in arrears, or if legal acon is instuted, I agree to pay all legal costs, including the charges between aorney and client, collecon charges,

tracing costs and commission. I consent in terms of Secon 65J of the Magistrate’s Court Act No 32 of 1944 to an emoluments aachment order to

be issued, without further noce to me, from the court of the district in which my employer resides, carries on business, or is employed, and that the

amount of the emoluments be aached in installments as reected in my agreement with Oxbridge Academy.

• Oxbridge Academy may cede this agreement.

• Please note that your informaon would be part of our database and could be used for Oxbridge Academy related markeng purposes.

Agreement

Courier fee for Internaonal

students will be levied

separately on a cost basis.