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NMMU Business School
Main Campus and Administrative Head Office:
2nd Avenue, Summerstrand, Port Elizabeth,
South Africa, 6001
Tel: +27 (0-861-***-*** ********.******@****.**.** 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-****
1
05/2016
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-***-*** ********.******@****.**.** 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
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
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
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-***-*** ********.******@****.**.** 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-****
3
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
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 ****************@****.**.**
• 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-***-*** ********.******@****.**.** 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-****
4
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: **********@****.**.**
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-***-*** ********.******@****.**.** 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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