NMMU Business School

Main Campus and Administrative Head Office:

2nd Avenue, Summerstrand, Port Elizabeth,

South Africa, 6001

Tel: +27 (0-861-***-*** ac9d9a@r.postjobfree.com www.leadersfortomorrow.co.za Satellite Support Offices:

East London and Border Kei - Tel: +27 (0-41-504-**** George and Southern Cape - Tel: +27 (0-44-873-**** KwaZulu-Natal - Tel: +27 (0-31-508-****

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APPLICATION / REGISTRATION FORM

SHORT LEARNING PROGRAMMES

SECTION 1: PROGRAMME DETAILS - ALL FIELDS ARE COMPULSORY (Please Complete In Block Letters) Module

Programme Date(s)

Closing Date for Application

Cost

Coordinator

Coordinator Contact Details

Programme to be Attended In

Port Elizabeth

East London

George

KZN

Were you previously a student of the former UPE / PE Tech / NMMU / Vista PE? Yes

No

Previous Student Number(s)

SECTION 2: PERSONAL DETAILS OF APPLICANT

SECTION 2.1 STUDENT INFORMATION

Title

Rev

Prof

Dr

Mr

Mrs

Ms

Surname

Full First Names

Preferred First Name

Married

Nationality

SA ID No.

SA Passport No.

International Passport No. (International Students) International Permit No. (International Students)

Date of Birth DD

MM

YYYY Gender

Male

Female

Ethnicity (For Statistical Purposes)

Asian

Black

Coloured

Indian

White

Home Language

Age Group

18 - 22

23 - 29

30 - 39

40 - 49

50+

Disability (Please Specify If Applicable)

Residential Address

Suburb

City

Country

Code

Postal Address

Suburb

City

Student Number:

Ensure the following

documents are attached

to your application form:

- Certified Copy of ID or Passport

- Proof of Address / Copy of

Recent Utility Bill

- Proof of Payment / Order No.

- International Students:

Copy of Valid Passport and

Study VISA or Home Affairs

Endorsement

STUDENT CHECKLIST

FOR OFFICE USE ONLY

Other (Specify)

Indicate Additional Support Required

Single Maiden Name (if applicable)

NMMU Business School

Main Campus and Administrative Head Office:

2nd Avenue, Summerstrand, Port Elizabeth,

South Africa, 6001

Tel: +27 (0-861-***-*** ac9d9a@r.postjobfree.com www.leadersfortomorrow.co.za Satellite Support Offices:

East London and Border Kei - Tel: +27 (0-41-504-**** George and Southern Cape - Tel: +27 (0-44-873-**** KwaZulu-Natal - Tel: +27 (0-31-508-****

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05/2016

Country

Code

Home Tel

Work Tel

Cell

Email

Fax

Dietary Requirements (Applicable To Full Day Classes Only - Please Select One) Halaal

Kosher

Vegetarian

Vegan

Diabetic

None

SECTION 2.2 NEXT OF KIN

Name & Surname

Relationship

Residential Address

Suburb

City

Country

Code

Home Tel

Work Tel

Cell

Email

Fax

SECTION 3: EDUCATION

SECTION 3.1 HIGHEST QUALIFICATION

Degree / Diploma / Certificate

Completed

Yes

No

Year

Institution

Student No. (If Available)

SECTION 3.2 COMPUTER LITERACY

MS Word

MS Projects

MS Powerpoint

MS Access

MS Excel

Internet / Email

None Of The Above

Other (Specify)

SECTION 4: EMPLOYMENT HISTORY & EXPERIENCE (Attach Curriculum Vitae) CURRENT EMPLOYMENT

Company (Employer) Name

Company Physical Address

Suburb

City

Country

Code

Position Held (Job Title)

Department

No. Of Years In This Position

No. Of Subordinates Reporting To You

HR Division: Contact Person’s Name & Surname

Job Title

Tel

Cell

Email

SECTION 2.1 STUDENT INFORMATION (Continued)

NMMU Business School

Main Campus and Administrative Head Office:

2nd Avenue, Summerstrand, Port Elizabeth,

South Africa, 6001

Tel: +27 (0-861-***-*** ac9d9a@r.postjobfree.com www.leadersfortomorrow.co.za Satellite Support Offices:

East London and Border Kei - Tel: +27 (0-41-504-**** George and Southern Cape - Tel: +27 (0-44-873-**** KwaZulu-Natal - Tel: +27 (0-31-508-****

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05/2016

SECTION 5: PAYMENT DETAILS

Who will be responsible for paying the account?

Private

Company

Purchase Order / Order No. / GRA No. (For Company) Name & Surname of Responsible Person

Job Title

Department

Company Name (If Applicable)

Company VAT Reg No. (If Applicable)

Postal Address (For Account Purposes)

Suburb

City

Country

Code

Tel

Cell

Email

Fax

Authorised Signature (Manager / Individual)

Print Name & Surname

Job Title

Date

Banking Details:

NAME OF ACCOUNT: Nelson Mandela Metropolitan University TRADING NAME: NMMU Business School

TYPE OF ACCOUNT: Business Current Account

ACCOUNT NUMBER: No. 331 934 167

STANDARD BANK BRANCH: Rink Street, PE

BRANCH CODE: 050 417

SWIFT CODE: SBZAZAJJ (If Applicable)

• Payment can be done via EFT transfer, cheque/cash deposits at the bank or cash payments at the cashier on an NMMU campus.

(Please note: NO payment must be made to any other NMMU staff member.)

• Reference on deposit slip must indicate INVOICE NUMBER & Student’s initial & surname

• Fax deposit slip or EFT receipt as proof of payment to 041-******* OR email to ac9d9a@r.postjobfree.com

• Please note that, should the individual be responsible for payment of the account, a copy of a utility bill or proof of address should accompany the application form

• Please note that, should the company be responsible for payment of the account, a signed letter from an authorised person confirming the arrangements must be attached to the application form

• Purchase order number, GRA number and a copy of the order documentation should accompany the application form Payment Terms:

• Companies: Payment is due 30 days from date of invoice

• Private Individuals: Payment is due before commencement of the programme SECTION 6: FOR BUSINESS SCHOOL MARKETING & CORPORATE RELATIONS Where/how did you hear about us?

Employer / Manager / HR

Colleague at work

Friend or Family Member

Newspaper Advertisement

Radio Advertisement

Online Advertisement

Newspaper Story about programme or Business School Email

Internet Search

NMMU Business School website

NMMU Business School event

Expo

Other (Specify)

NMMU Business School

Main Campus and Administrative Head Office:

2nd Avenue, Summerstrand, Port Elizabeth,

South Africa, 6001

Tel: +27 (0-861-***-*** ac9d9a@r.postjobfree.com www.leadersfortomorrow.co.za Satellite Support Offices:

East London and Border Kei - Tel: +27 (0-41-504-**** George and Southern Cape - Tel: +27 (0-44-873-**** KwaZulu-Natal - Tel: +27 (0-31-508-****

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05/2016

Why did you select NMMU Business School for your studies? Can we add you to our database for electronic news, articles and marketing? Yes

No

SECTION 7: DECLARATION BY APPLICANT

I, Print Full Names) declare that the above information supplied by me is, to the best of my knowledge, true and correct. I agree to comply with all the requirements of my enrolment and accept the rules and regulations governing NMMU, the Business School and the Programme. It will remain my responsibility to understand the rules and regulations as contained in the Student Guidelines (www. leadersfortomorrow.co.za) of NMMU, the Business School and the Programme. I undertake to comply with the Student Disciplinary Code and Copyright Policies of NMMU.

Print Name & Surname

Signature

Date

Please read the information contained in this section carefully. (The Full Student Guidelines Document Is Available On: www.leadersfortomorrow.co.za) The contents of this contract constitutes an agreement between the student and NMMU Business School. 1. Registration of Students

Acceptance and registration of students are subject to relevant admission requirements for the programme. The Business School reserves the right to cancel short learning programmes due to lack of demand. Any outstanding fees, owed either to NMMU or NMMU Business School, must be settled before register- ing for a short learning programme. Students have to submit the original application/registration form when attending the first class. NMMU Business School must be informed of certain disabilities to determine whether it is able to make special arrangements to accommodate persons with disabilities. Advice can be obtained from the senior disability officer at NMMU Disability Unit on 041-***-**** / 2313 / 4756 or Email: ac9d9a@r.postjobfree.com

2. Fees

The fees and conditions shall be determined by NMMU Business School and are subject to amendment without prior notice. Once an application has been accepted, the student/sponsoring company becomes liable for payment of the full programme fee and will not be exempted from any part of such obliga- tion. The programme fee should be settled before commencement of the programme. The fees are all inclusive and include all relevant training, lecture and course materials. Cheques should be made payable to NMMU (see banking details in section 5). Interest will be charged on outstanding accounts exceeding 30 days at the interest prime rate (prime rates are subject to change). In the event of the university successfully instituting legal action against the student for the recovery of any amounts owing, due and payable or the enforcement of any legal rights of the university, the student shall be liable to pay all legal costs incurred on an attorney and client scale, including the collection commission and interest. The student’s certificate and study record may be withheld under the following circumstances:

• In the event of the student account being in arrears or

• In the event of any disciplinary matter pending against the student 3. Programme Cancellations

3.1 Open Programmes

3.1.1 In the event that NMMU cancels the Open Programme due to insufficient numbers registered, students/sponsors will be reimbursed in full. 3.1.2 If the student/sponsor wishes to cancel his/her enrolment on a Short Learning Programme (SLP) and: a. The student/sponsor has applied but the application has not yet been accepted, then there will be no charge. b. The student/sponsor has applied and been accepted, but class has not yet commenced: i. And the cancellation is received by NMMU ten (10) or more working days before commencement of the SLP, then there will be no charge. ii. However, if the cancellation is received by NMMU less than ten (10) working days before the commencement of the SLP, then the full cost of the SLP is payable.

c. The classes have commenced, then the student/sponsor will be liable for the full cost of the SLP, whether the student has attended or not. SECTION 8: TERMS AND CONDITIONS (Extract from the Student Guidelines document) SECTION 6: FOR BUSINESS SCHOOL MARKETING & CORPORATE RELATIONS (Continued) In-House Delivery

Existing and bespoke client specific programmes, with the exclusion of academic diploma or degree programmes, are presented across South Africa and Africa at client premises or client-approved venues and facilities. 5

NMMU Business School

Main Campus and Administrative Head Office:

2nd Avenue, Summerstrand, Port Elizabeth,

South Africa, 6001

Tel: +27 (0-861-***-*** ac9d9a@r.postjobfree.com www.leadersfortomorrow.co.za Satellite Support Offices:

East London and Border Kei - Tel: +27 (0-41-504-**** George and Southern Cape - Tel: +27 (0-44-873-**** KwaZulu-Natal - Tel: +27 (0-31-508-****

05/2016

4. Programme Postponements

4.1 Open Programmes

4.1.1 In the event that NMMU postpones the programme, due to insufficient numbers registered, the students/sponsors will be reimbursed in full. In the event that a student/sponsor elects to receive a refund, such request should be done in writing. The student is advised to keep evidence of the date on which such request is sent.

4.1.2 Postponement requests by the student are not allowed for Short Learning Programmes (SLP). The student should cancel and re-apply if the student wants to attend at a later stage.

4.2 Client Specific In-house and On-Campus Training - Standard Programmes Once confirmation has been received in the form of a signed quote, an order number and/or a signed Service Level Agreement/Memorandum of Understanding, standard training programmes may be postponed once without any additional penalties. The sponsoring company will be billed for all costs associated with the postponement request (such costs may include: venue/equipment hire, travel & accommodation costs, facilitator availability, etc.). In the event that the programme has been rescheduled and then again postponed or cancelled, the company will become liable for the full cost as per the quotation. 4.3 Client Specific / Newly Developed Programmes

Once confirmation has been received in the form of a signed quote, an order number and/or a signed Service Level Agreement/Memorandum of Understanding for the customisation of standard programmes or the development of new programmes, NMMU will commence with the development process and the company will become liable for the full development/customisation cost. 5. Certificates

Kindly allow 3 months from the submission of assignments before collection of certificates, unless otherwise stipulated. 6. Class attendance

80% attendance is required per module failing which a student will have to repeat the module at 50% of the current module fee in order to be assessed. Where a student fails to notify the relevant programme coordinator of his/her intended non-attendance within the required timeframe, the student/ sponsoring company will be held liable for the fees, as if the student/company had attended. The student/sponsoring company will then be expected to pay the full fee again should the relevant payor indicate his/her intention to attend the same module at a later date. 7. Assessment Strategy

Students and sponsoring companies must ensure that they are familiar with the Assessment Strategy applied by the NMMU Business School: Leadership Academy division. This information is available on the Business School website and in the Student Guideline Document which will be discussed during the orientation phase. It is important to note that there might be cost implications attached to unsuccessful modules. 8. NMMU Policy Framework

Students enrolling with the NMMU Business School must abide to NMMU Polices of which the “NMMU Student Disciplinary Policy” and “Policy for the Promotion of Academic Integrity and Prevention of Plagiarism” have special reference . 3.2 Client Specific In-house and On-Campus Training - Standard Programmes Once confirmation has been received in the form of a signed quote; an order number; and/or a signed Service Level Agreement/Memorandum of Understanding, a 40% cancellation fee on the full quoted amount will apply to cancellations received 20 or more working days prior to commencement of training. Where cancellations are made less than 20 working days prior to commencement, the company will be liable for the full cost as per quote. 3.3 Client Specific / Newly Developed Programmes

Once confirmation has been received in the form of a signed quote; an order number; and/or a signed Service Level Agreement/Memorandum of Understanding, a 60% cancellation fee on the total quoted amount will apply to cancellations received 20 or more working days prior to commencement of customised training and programmes developed on company request. Where cancellations are made less than 20 working days prior to commencement, the company will be liable for the full cost.

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