Registration

Contact Information
Fullname

First Name
Last Name
Company Name
Optional
Email
Contact Number

Course Pricing
Course
Currency
Your total amount is R {Currency} ex VAT
Billing Details
Do you work for change logic?
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Payment Mode

Address

Street Address
Street Address 2
City	State / Province
Postal / ZipCode	Country

EFT payment details are available on the next page.
Your total amount is R {Currency} ex VAT

Banking Details and Submission

BANK NAME
Account Number:	000 000 182 1806
Branch:	Norwood / 004105
Branch Number:	00 41 05
Swift Code:	SBZAZAJJ
Reference:	Invoice Number

Once we have received payment, we will send you a confirmation email.

Your total amount is R {Currency} ex VAT
I agree to paying / being debited the full amount stipulated above in order to attend the chosen course.
I agree