REGISTRATION FORM. CAMELOT INTERNATIONAL (PTY) LTD DOCUMENT CHECK LIST Please complete all pages in Black Pen Only.

Transcription

1 REGISTRATION PACK

2 REGISTRATION FORM CAMELOT INTERNATIONAL (PTY) LTD DOCUMENT CHECK LIST Please complete all pages in Black Pen Only. NAME OF STUDENT: DATE: SALES CONSULTANT: BRANCH: COURSE COMMENCEMENT: Please tick the documents that will accompany the Registration form. Annexure A - Fees Agreement (To be completed by sponsor) Identification Document (Certified Original Copy of the student and sponsor) I.D. Photographs (x2) Instalment Terms Agreement Form (To be completed by sponsor) Matriculation Certificate/Results * (Certified Original Copy - only required for courses longer than one week) Medical Certificate of general good health * (Only required for courses longer than one week) Registration Form/Contract (To be completed by student and signed by student and sponsor) Testimonial from School * (Only required for courses longer than one week) Motivational Letter from Student * Proof of Residence (Person Responsible for account) Comments (Office Use Only) Official Use *Not required for Modular course registrations. Page 1 of 11

3 REGISTRATION FORM A. PARTICULARS OF APPLICANT FULL NAME SURNAME ID NUMBER DATE OF BIRTH AGE MARITAL STATUS HOME NUMBER CELL PHONE NUMBER ADDRESS PERMANENT HOME ADDRESS POSTAL ADDRESS B. PARTICULARS OF PARENTS/GUARDIAN/SPOUSE SURNAME NAME HOME NUMBER CELL PHONE NUMBER ADDRESS EMPLOYER NAME OCCUPATION WORK NUMBER WORK ADDRESS Father / Spouse C. QUALIFICATIONS (STUDENT) Mother NAME OF SECONDARY SCHOOL ATTENDED YEAR COMPLETED AND GRADE FINAL SUBJECT AND SYMBOLS POST MATRICULATION Page 2 of 11

4 CAMELOT INTERNATIONAL (PTY) LTD CONTRACT 1. I (Student names in full) Duly assisted by (Parent/Guardian/Spouse) 2. I do hereby enrol for the CAMELOT INTERNATIONAL HEALTH & SKIN CARE TRAINING course upon the terms and conditions hereunder: 2.1 The Course Contract Price R 2.2 The Course Contract Price R 2.3 The Course Contract Price R 2.4 The Estimated Kit Price R_ 3. I agree to pay the total contract price of R 4. I agree that in the event of my failing to attend lectures for any reason whatsoever, and no longer continuing with the course this will not reduce my liability for the contract price of the course shall immediately become due and payable upon demand. 5. I agree and understand that no variation, alteration or consensual cancellation additional to this contract shall be binding upon myself and Camelot unless reduced to writing and signed by both myself and Camelot, Camelot International reserves the right to change course syllabus, lecture times and student fees. I understand that only a limited number of students enrol for the course, and accordingly I agree in the event of this contract being cancelled for any reason whatsoever by myself/parent/guardian/ spouse, the contract price for the course shall not be transferable or refundable and I agree to pay the entire contract price of the course on demand. 6. In the event of Attorneys being instructed to recover any amounts due in terms of the contract, I will be liable for the costs on the attorney and own client costs and collection charges on all amounts collected. 7. Students shall not be permitted to enter and write the national & international examinations unless the contract price and all other amounts which may be outstanding to Camelot have been paid in full. 8. Should students loans fall beyond 60 days in arrears students will not be permitted to attend lectures. 9. I agree that interest will be charged on any outstanding amounts. 10. I hereby indemnify and hold Camelot harmless for any loss or damage of whatsoever nature I may suffer whilst attending lectures at Camelot, or any outing, on assignment or for any other reason whatsoever. 11. I consent to the jurisdiction of the Magistrate s Court for the purpose of any action or legal proceedings which Camelot may institute in respect of any claims of whatsoever nature arising from this contract. 12. I accept as my domicilium citandi et executandi my address as stipulated in paragraph A of the application form. STUDENT I, the undersigned do hereby agree to be jointly and severally liable for the contract price of the course and accept all the terms and conditions as stipulated herein to be binding on me. _ STUDENT SIGNATURE PARENT/GUARDIAN/SPOUSE _ WITNESS _ WITNESS I, the undersigned do hereby agree to be jointly and severally liable for the contract price of the course and accept all the terms and conditions as stipulated herein to be binding on me. PARENT / GUARDIAN / SPOUSE SIGNATURE WITNESS _ WITNESS CAMELOT INTERNATIONAL I, the undersigned do hereby agree to and accept the terms and conditions stipulated herein. _ CAMELOT SIGNATURE _ WITNESS _ WITNESS Page 3 of 11

5 ANNEXURE A: CAMELOT INTERNATIONAL (PTY) LTD FEES AGREEMENT The right to collect fees may be ceded by Camelot International (Pty) Ltd in which case the payment terms of the cessionary shall become applicable. Person responsible for Payment of Account (please attach a copy of front page of ID book) TITLE INITIALS SURNAME FIRST NAMES ID NUMBER PHYSICAL ADDRESS CODE POSTAL ADDRESS CODE TEL (H) CELL TEL (W) Company Sponsor COMPANY NAME COMPANY REGISTRATION NUMBER PHYSICAL ADDRESS CODE POSTAL ADDRESS CODE TEL A: PAYMENT TERMS Please tick an option accordingly. TERMLY X 4 MONTHLY X 9 MONTHLY X 10 (Beauty Tech Only) MONTHLY X 11 CASH EFT Payment Date B: PAYMENT TERMS Please tick an option accordingly. DEPOSIT PAID (25%) INSTALMENT PAID DEBIT ORDER CREDIT CARD CHEQUE POSTAL ORDER If any option is chosen from B above, please complete ANNEXURE B Page 4 of 11

6 C: COURSES & KITS Indicate below courses enrolled for: MODULAR COURSES Generic Subjects are a pre-requisite for all Modular Courses. * Swedish Body Massage is a pre-requisite for this course. ** Anatomy, Physiology & Pathology is a pre-requisite for this course. GENERIC SUBJECTS FIRST AID LEVEL I HEALTH & HYGIENE BUSINESS STUDIES ALLIED HEALTH PROFESSIONS COUNCIL RPL BRIDGING COURSE ANATOMY, PHYSIOLOGY & PATHOLOGY ANATOMY, PHYSIOLOGY & PATHOLOGY - DISTANCE LEARNING COURSE DIET & NUTRITION THEORY I & II EYELASH AND EYEBROW TINTING & SHAPING, AND EYELASH EXTENSIONS EYELASH AND EYEBROW TINTING & SHAPING EYELASH EXTENSIONS MAKE-UP TECHNIQUES I MANICURE & PEDICURE SWEDISH BODY MASSAGE WAXING ADVANCED MASSAGE BAMBOO MASSAGE * CALABASH MASSAGE * COLD GLASS THERAPY * HAWAIIAN MASSAGE * HOT STONE THERAPY * INFANT AND PREGNANCY MASSAGE WORKSHOP * INDIAN HEAD MASSAGE RUNGU MASSAGE * BODY THERAPIES BODY THERAPY I ** BODY THERAPY II SKINCARE THERAPIES SKINCARE THERAPY I SKINCARE THERAPY II (SKIN ELECTROTHERAPY) LASER THERAPY ADVANCED THERAPIES IRIDOLOGY ** MANUAL LYMPH DRAINAGE * ** SHIATSU MASSAGE ** THAI MASSAGE SPORTS MASSAGE * ** NAIL TECHNOLOGY NAIL TECHNOLOGY ACRYLIC DIP SYSTEM NAIL EXTENSIONS (SCULPTURE) NAIL ART SPA THERAPY SPA MANAGEMENT CERTIFICATE OF BEAUTY TECHNOLOGY DIPLOMA COURSES DIPLOMA IN HEALTH & SKINCARE THERAPY 1ST YEAR 2ND YEAR DIPLOMA IN HOLISTIC & NATURAL THERAPY 3RD YEAR DIPLOMA IN THERAPEUTIC AROMATHERAPY 1ST YEAR 2ND YEAR DIPLOMA IN THERAPEUTIC REFLEXOLOGY 1ST YEAR 2ND YEAR DIPLOMA IN THERAPEUTIC MASSAGE THERAPY 1ST YEAR 2ND YEAR BCOM (BUSINESS MANAGEMENT) To apply on DaVinci Application form (On Request) Page 5 of 11

7 D: DECLARATION AND UNDERTAKING I acknowledge that I have familiarized myself with this contract, the Camelot International (Pty) Ltd Prospectus, Rules and Regulations and relevant documentation and certify that the information given in this contract is accurate and complete in all respects. a) We choose our domicilium citandi et executandi as stipulated herein. b) Interest will be charged at the maximum permitted by the Usury act on all overdue accounts. c) In the vent of legal action being instituted for the recovery of fees payable in terms of this application, you will be liable for the attorney costs. d) The outstanding amount owing to Camelot International can be proved by a certificate signed by an accounting officer of Camelot International (Pty) Ltd. Such certificate will be prima facie proof of the amount outstanding and the appointment of the said accounting officer need not be proved. PARENT / LEGAL GUARDIAN DATE I hereby accept that I am jointly and severally liable for payment of tuition fees of the above applicant. PERSON RESPONSIBLE FOR ACCOUNT DATE I hereby accept that I am jointly and severally liable for payment of tuition fees of the above applicant. Page 6 of 11

8 ANNEXURE B CAMELOT INTERNATIONAL (PTY) LTD PAYMENT FORM STUDENT/SPONSOR NAME STUDENT NUMBER SOLACE ACCOUNT NUMBER PHONE NUMBER OF PAYEE WORK TEL CELL HOME TEL CREDIT CARD PAYMENT I, the undersigned, hereby authorise Camelot International (Pty) Ltd to deduct the specified amount from my credit card. PAYMENT METHOD CREDIT CARD MASTERCARD VISA CCV NUMBER (Last three (3) digits on back of card CREDIT CARD NUMBER TOTAL AMOUNT CARD HOLDER NAME CREDIT CARD INSTRUCTIONS EXPIRY DATE STRAIGHT BUDGET ID NUMBER OF CARD HOLDER NUMBER OF MONTHS I hereby authorise Camelot International (Pty) Ltd to deduct from the above mentioned account, the monthly or other amount as specified. I also understand that if I do not supply the relevant information or the correct information, I cannot hold Camelot International (Pty) Ltd responsible for non-payment of my account. SIGNATURE OF DATE ACCOUNT HOLDER Page 7 of 11

9 ANNEXURE C AUTHORITY AND MANDATE IN RESPECT OF ALL ELECTRONIC DEBITS A. AUTHORITY Given by :( name of account holder) _ Address: Bank: _ Branch and code: Account number: Type of account: current (cheque) / savings / transmission [delete that which is not applicable] Amount: Date: To: Camelot International (Pty) Ltd 7 11th Avenue Houghton 2121 This signed Authority and Mandate refers to our contract dated_ ( the Agreement ) I/We hereby authorise you to issue and deliver payment instructions to your banker for collection against my/our above mentioned account at my/our abovementioned bank (or any other bank or branch to which I/we may transfer my/our account) on condition that the sum of such payment instructions will never exceed my/our obligations as agreed to in the Agreement, and commencing on and continuing until this Authority and Mandate is terminated by me/us by giving you notice in writing of not less 20 ordinary working days, and sent by prepaid registered post or delivered to your address indicated above. The individual payment instructions so authorised to be issued must be issued and delivered as follows [DELETE THAT WHICH IS NOT APPLICABLE]: i. On the day ( payment day ) of each and every month commencing on _. In the event that the payment day falls on a Saturday, Sunday or recognized South African public holiday, the payment day will automatically be the very next ordinary business day. Further, if there are insufficient funds in the nominated account to meet the obligation, you are entitled to track my account and re-present the instruction for payment as soon as sufficient funds are available in my account; ii. monthly; on or after the dates when the obligation in terms of the Agreement is due and the amount of each individual payment instruction may not be more or less than the obligation due; iii. bi-monthly; on or after the dates when the obligation in terms of the Agreement is due and the amount of each individual payment instruction may not be more or less than the obligation due; iv. three-monthly; on or after the dates when the obligation in terms of the Agreement is due and the amount of each individual payment instruction may not be more or less than the obligation due; v. six-monthly; on or after the dates when the obligation in terms of the Agreement is due and the amount of each individual payment instruction may not be more or less than the obligation due; Page 8 of 11

10 vi. vii. viii. annually; on or after the dates when the obligation in terms of the Agreement is due and the amount of each individual payment instruction may not be more or less than the obligation due; weekly; on or after the dates when the obligation in terms of the Agreement is due and the amount of each individual payment instruction may not be more or less than the obligation due; bi-weekly; on or after the dates when the obligation in terms of the Agreement is due and the amount of each individual payment instruction may not be more or less than the obligation due. I /We understand that the withdrawals hereby authorised will be processed through a computerized system provided by the South African Banks and I also understand that details of each withdrawal will be printed on my bank statement or on an accompanying 54 voucher. Such must contain a number, which number must be included in the said payment instruction and if provided to you should enable you to identify the Agreement. This number must be added to this form in section E before the issuing of any payment instruction and communicated to me directly after having been completed by you. I/We shall not be entitled to any refund of amounts which you have withdrawn while this authority was in force, if such amounts were legally owing to you. B. MANDATE I/We acknowledge that all payment instructions issued by you shall be treated by my/our above mentioned bank as if the instructions had been issued by me/us personally. C. CANCELLATION I/We agree that although this Authority and Mandate may be cancelled by me/us, such cancellation will not cancel the Agreement. I/We shall not be entitled to any refund of amounts which you have withdrawn while this authority was in force, if such amounts were legally owing to you. D. ASSIGNMENT I/We acknowledge that this authority may be ceded or assigned to a third party if the Agreement is also ceded or assigned to that third party, but in the absence of such assignment of the Agreement, this Authority and Mandate cannot be assigned to any third party. Signed at on this day of Signature as used for operating on the account Assisted by FOR OFFICE USE E. AGREEMENT REFERENCE NUMBER This agreement reference number is: Page 9 of 11

11 CAMELOT INTERNATIONAL (PTY) LTD FEE PAYMENT PROCEDURE AGREEMENT I, (name of student) confirm that I have read, understood and accepted payment procedures as stipulated by Camelot International (Pty) Ltd. SIGNATURE OF STUDENT I, (name of parent/guardian) confirm that I have read, understood and accepted payment procedures as stipulated by Camelot International (Pty) Ltd. SIGNATURE OF PARENT ACKNOWLEDGEMENT OF STUDENT POLICIES AND PROCEDURES I, Mr/Mrs (Parent / Guardian) hereby acknowledge receipt of and accept the conditions stipulated in the Student Policies and Procedures Document. SIGNATURE OF PARENT I, (Student Name) hereby acknowledge receipt of and accept the conditions stipulated in the Student Policies and Procedures Document. SIGNATURE OF STUDENT Page 10 of 11

12 GENERAL POLICIES AND PROCEDURES FOR GENERIC SUBJECTS This section applies for Modular course registrations The Learner needs to register for the following Generic subjects - Business Studies - Health & Hygiene - First Aid Level I The Learner needs to complete the generic subjects within three (3) months from the date of registration. Should the learner be unable to attend the above courses within the stipulated period he or she will have to re-register and pay for the generic subjects in full. In the event that a learner is absent for a final assessment he / she will be liable for a re-write fee of R for theory and R for practical which needs to be paid before entering into the assessment and a doctors certificate needs to be presented. If the learner cannot attend classes a letter needs to be faxed to the Part Time Division at least forty eight hours prior to commencement of class! No exceptions will be made. Please refer to the fee schedule information for any additional information on payment of courses and course attendance! Should you require any further information) please do not hesitate to contact the Part Time Division on POLICIES AND PROCEDURES FOR GENERIC SUBJECTS I, (name of learner) confirm that I have read) understood and accepted the policies and procedures regarding Generic Subjects issued by Camelot International Pty_ Ltd! SIGNATURE OF STUDENT FIRST AID LEVEL ONE The First Aid lectures consist of two days (18 Hours) of lectures. If the student refrains from attending the course without a doctor s letter stating that they were unable to attend the course, they will be liable for payment thereof and will be invoiced and billed R for the First Aid Level One Course. This is due to the fact that we outsource our First Aid training and are billed for each confirmed student enrolling for the course. I, (name of learner) the undersigned agree to the terms mentioned above, and is solely responsible for attending the course once confirmed and booked. SIGNATURE OF STUDENT Page 11 of 11

13 CERTIFICATE DETAIL FORM Dear Student, Please complete the following details on this certificate request form on the line that is provided below. Please write your name and surname in capital letters. NAME SURNAME The above information is vitally important as it will be printed on your certificate or diploma. After completion of your course, your name and surname will appear on your certificate or diploma. Thank you Camelot Management Page 1 of 1