Course Registration

Course Information

Telephone: +27 72 602 2049
E-Mail - [email protected]

To register for a course please complete and submit the form on the right
Please use your surname and course date as the reference for the payment
Confirmation of your registration will be sent to you via sms or email once payment has been made

Account Name:
Bank Name:
Account No:
Branch Code:
Branch Name:
Account Type:

Mighty Wings Life Centre
Standard Bank
421-488-506
009953
Fourways Crossing
Cheque

* Indicates required field

Course Name *

Day *

Month *

Year *

Name *

First

Last

Cell Number *

Email *

Fee *

Payment Method *

Number Attending *

Submit