ONLINE APPLICATION FORM

WN Occupational Health and Safety Academy

‘Safety Training parred with Excellence”

Please read the instructions carefully before completing this form. Ensure you have the following documents ready for upload in PDF or JPEG format:

Certified Copy of ID/Passport
Certified Copies of Academic Transcripts/Certificates
Not Applicable To Short Courses

Note:

All fields marked with an asterisk (*) are mandatory.
Incomplete applications or those without the required documents will not be processed.
By submitting this application, you agree to our Terms and Conditions and acknowledge that the information provided is accurate and true to the best of your knowledge.

COMPLETE ALL SECTIONS

APPLICATION FORM – SHE COMBO

16 - 20 December 2024

Title

D.O.B

Name

Initials

Surname

Identity Nr

Gender

Male Female

Home Langauge

Town

Region

Phone Number

Email Address

Please select the course/s you want to attend

How do you intend to pay for your studies?

Employer Private Other

If Other Please specify.

Terms & Conditions (Please review and ensure you fully understand the content of this agreement. By ticking the checkbox, you confirm your agreement and acceptance of its terms)

WN Occupational Health & Safety Academy (referred to as WN OHSAC hereinafter) reserve the right to refuse any application not meeting the criteria for registration as a student at WN OHSAC.

The Applicant accepts the terms and conditions and any rules and regulations attached to any of the courses enrolled for, by signature hereof.

Please take note that 50% of the course fee must be paid in order to secure your place.

It is the responsibility of the applicant to ensure that any outstanding fees are paid to WN OSHAC, whether you are self-sponsored or sponsored by a parent/employer/scholarship.

I hereby declare that the provided information on this application is true and accurate in every sense.
I understand that providing false information is against the law and if it is discovered at any stage that the information I provided is inaccurate or false, this could render my application for enrollment invalid and offer withdrawn.

Yes No

Please ensure the following documents are fully certified:
Certfified Identity Document