Evers Xcellence Online Registration Form

Please complete our online course enrolment form for the Academic Year of 2020. The online form has 3 compulsory Sections to complete. Please ensure you fill all the fields. We will also phone you as soon as possible to chat about your education. Email proof of payment to sales@.

Please Note: Banking Details

Bank Name: First National Bank

Account Name: Evers Xcellence Management Consulting (Pty) Ltd.

Account No: 62417108398

Branch Code: 231002

Reference: Your Name & Surname

Section 1: Personal Information

Last name*

First name*

Gender/Sex*

RSA ID Number*

Email*

Phone number*

Street address*

City*

Postal Code*

Upload Certified ID Copy*

Section 2: Online Course Information

Course Title*

Date Start*

Year/Month/Day

Date End*

Year/Month/Day

SAQA ID Number*

Total Price*

Deposit*

Monthly Installment*

Section 3: Educational Background Information

Highest Grade Passed*

Year Completed*

Name of Institution*

I declare that the submitted information is accurate and correct to the best of my knowledge.*