DMR Institute of Beauty - Full-Time Registration Form

Full-Time Course Registration Form

"*" indicates required fields

Date

Name of Student Advisor (If Applicable)

Branch

Course Commencement

Student Number

STUDENT DETAILS

Name*

First Last

Cellphone Number*

Email*

Enter Email Confirm Email

Date of Birth*

Identity Number*

If you do not have an ID Number please enter your passport number

Passport Number

Upload a certified copy of your ID or Passport

Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 96 MB.

Upload an ID or Passport photo

Drop files here or

Accepted file types: jpg, png, Max. file size: 96 MB.

If you are unable to do this, you may bring in your ID photo.

Upload a copy of your Student Permit (If Applicable)

Drop files here or

Accepted file types: jpg, png, pdf, Max. file size: 96 MB.

Permanent Home Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Language

Gender Identity

Resident Status

PARTICULARS OF PARENT/GUARDIAN IF APPLICANT IS UNDER 21

Name

First Last

Cellphone Number

Employer

Occupation

Work Phone

Work Address

Street Address Address Line 2 City State / Province / Region

ACADEMIC DETAILS

Name of Institution Attended

Highest Qualification Achieved

Qualification Year

Attach Latest Results

Max. file size: 96 MB.

Certified Original Copy - only required for courses longer than one week)

COURSE SELECTION

Course Name

PERSON RESPONSIBLE FOR ACCOUNT

Who is paying for your studies?

Payment Terms

Parent/Guardian/Sponsor Name

First Last

Parent/Guardian/Sponsor Cell Number

Parent/Guardian/Sponsor Email

Parent/Guardian/Sponsor ID No

Company Registration No (If company sponsor)

Parent/Guardian/Sponsor Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

PAYMENT TERMS

EFT

Credit Card

Debit Order

Annexure C

Full Payment

Course Fee will be paid in full

UNIFORM SIZES

Tunic

Please state your size eg. 34

Pants

Please state your size eg. 34

Overtop

Please state your size eg. 34

Jersey

Please state your size as eg. X Small, Small etc.

Full-Time Course Registration Form

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