| First
Name |
|
| Surname |
|
| Gender |
|
|
ID No.(SA
Citizens)
Passport
No. (International)
|
|
| Date
of Birth |
|
| Driver's
Licence details |
|
| Residential
Address |
|
| Postal
Address |
|
| Tel |
|
| Mobile |
|
| Fax |
|
| Email
|
|
| Which
courses are you interested in? See dates on courses page |
|
|
Highest
qualification obtained
|
|
|
Any
other conservation courses attended? Give the details
|
|
|
Are you
vegetarian or are there any foods you don't eat ?
|
I
am vegetarian |
|
| I
eat pork |
|
| I
eat beef |
|
| I
eat fish |
|
| I
eat chicken |
|
| Any
other relevant information |
|
|
Are there
any medical conditions or allergies we should be aware of
|
|
|
Are you
covered by a medical aid fund. (For South African Resident only)
International
students should apply for health insurance in your home countries to
cover you while in South Africa
|
Yes
or No? |
|
| Membership
Number |
|
| Name
of fund |
|
| Principal
member |
| Full
Name |
|
| ID
Number |
|
|
Where did
you hear about Antares?
Please
state who told you about us or which website you found us on if this
is relevant
|
|
| Next
of kin details. These must be filled in for both parents and/or guardian. |
Relation |
|
|
| Name |
|
|
| Home
Contact number |
|
|
| Mobile
contact number |
|
|
| Occupation
|
|
|
|
Uniform
details
|
Please
advise us what shirt size you require.
(Only applicable
to 88-day course)
Size
|
|
I have
read the legal documents and agree to be bound by them
|
Legal documents; Indemnity and Code of Conduct
|
|
|
|
|
Top of
page
|
