R32,400.00 Plus VAT (R36,936.00)R34,800.00 Plus VAT (R39,672.00)

Name
Surname / First / Preferred
Postal Address:
Postal Code:
Contact Numbers: / ( ) / (Home) / Date of Birth:
( ) / (Office)
( ) / (Fax) / dd / MM / YYYY
(Cell)
Email Address: / (1)
(2) / Date of CTE Attendance
Educational Background: (Institution(s) attended, qualification(s) received:
Employer: / Job Title:
Length of employment: / Duties:
Describe the types of working relationships you have at your place(s) of work:
What is your experience of coaching people and being coached?
Invoicing Details
For the Attention of: / Company:
Invoicing Address:
Code:
VAT Registration No.:

Please include adigital photograph and letter of motivation (maximum 1 page) with your application form in which you describe your purpose in taking this course and what you hope to accomplish.

CAPE TOWNJOHANNESBURG

R32,400.00 plus VAT (R36,936.00)R34,800.00 plus VAT (R39,672.00)

(includes all course materials and refreshments)

DEPOSIT

A R3,500.00 non-refundable, non-transferable deposit is required to reserve a space.

(If your application is not accepted, your R3,500.00will be returned.) Please indicate your method of payment of the deposit:

ChequeDirect transfer Cheque Deposit

BALANCE

The balance of the tuition is due at the start of the course.For those who prefer an extended payment plan, you may choose one below. Please read the Cancellation Policy carefully to understand your financial obligation under an extended payment plan.

PAYMENT PLAN:

Please note that a deposit of R3,500.00 is requiredin order to secure your application.

ACC CAPE TOWN

Our full course fee exclusive of VAT is R 32,400.00 (including VAT R36,936.00) payable prior to commencement of course. A deposit of R 3,500.00 is required at least 1 month before to secure your place.

However should you choose to make use of our payment plan, the course fees inclusive of VAT will be:

Plan 1: R 1,140.00 additional charge on full fee. Payment within 3 months - full fee payable by 31 August 2011

Plan 2: R 2,280.00 additional charge on full fee. Payment before last session - full fee payable by 31 October 2011

Please note that full payment of fees before the commencement of the last session is mandatory failing which course certification will be withheld.

ACC JOHANNESBURG

Our full course fee exclusive of VAT is R 34,800.00 (including VAT R39,672.00) payable prior to commencement of course. A deposit of R 3500.00 is required at least 1 month before to secure your place.

However should you choose to make use of our payment plan, the course fees inclusive of VAT will be:

Plan 1: R 1,140.00 additional charge on full fee. Payment within 3 months - full fee payable by 30 September 2011

Plan 2: R 2,280.00additional charge on full fee.Payment before last session - full fee payable by 14 November2011

Please note that full payment of fees before the commencement of the last session is mandatory failing which course certification will be withheld.

METHOD OF PAYMENT:

Cheque (post-dated cheques must be included for extended payment plans)

Direct Deposit

Cheque Deposit

Paypal (overseas payments)

OUR BANK DETAILS:

(Please ensure you place your reference number on the invoice OR your name and the course e.g. SMerifieldACC on the payment)

Name: Centre for Coaching (Pty) Ltd

Bank: Nedbank Foreshore

Branch code: 108309

Acct number: 1083342754

Please note that your place on the course will only be confirmed upon receipt of the deposit.

CANCELLATION POLICY

Cancellations which occur 30 days or more prior to the course start date, are fully refundable less the non-refundable deposit. If cancellation occurs 30 to 14 days prior to the course start date, 50% of the program fee will be forfeited. If balance payment has not yet been made, 50% of the program fee becomes immediately due and payable. No refunds are possible after 14days prior to the course start date.Cancellations must be made in writing.

ACKNOWLEDGEMENT OF UNDERSTANDING:

I understand and agree that if I withdraw from the program at any time after 14 days prior to the course start date, the Centre for Coaching is entitled to keep and retain the full tuition as consideration for assuming the responsibilities in undertaking the program. If the tuition is being paid in installments, the full amount becomes immediately due and payable if, at any time and for any reason, I withdraw from the class.

I hereby acknowledge that I have read the Cancellation Policy and accept its terms.

Signed at ______on ______20___.

______

Signature

Applications can be submitted to:

Shaney MerifieldTel: +27 21 406-1493

Program ManagerFax:+ 27 21 406 1484

Centre for CoachingEFax: 086 508 2519

P.O. Box

Waterfront

8002