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Registration Form

General Information

Full Name

Date Of Birth:
CPR Gender

Email: Cell Phone Number Phone

Current Address

Employment Information

Are You Employed
Unemployed

Current Employer Phone

Email Address Fax:

Previous Job Title

Educational Record(Highter Education)

Professional Certificate Records(if any)

Training Course

Profitional Certificate Name(if requested)

Category Course Name

Previous Experience

Have you participated to any course related to this training course? Yes
No

If your answer is yes, kindly fill Course title, strength points, weak points

Other Suggestions

Course Expectations

Other Suggestions

Requirement

Special Requirement

Calendar

June 2023

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